文章摘要
桑永华,陈 亮,赵 飞.前列腺素E1在心肺转流过程中对血小板功能影响的研究[J].南京医科大学学报,2008,28(6):762~766
前列腺素E1在心肺转流过程中对血小板功能影响的研究
The study on the infuleunce of prostaglandin E1 on platelet function during cardiopulmonary bypass
投稿时间:2008-01-19  
DOI:10.7655
中文关键词: 前列腺素E1  心肺转流  血栓烷B2  6-酮-前列腺素F1  血小板超微结构
英文关键词: prostaglandin E1  cardiopulmonary bypass  TXB2  6-K-PGF1α  platelet ultrastructure
基金项目:
作者单位
桑永华 南京医科大学第一附属医院心胸外科,江苏 南京 210029 
陈 亮  
赵 飞  
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中文摘要:
      目的:研究前列腺素E1(PGE1)在心肺转流(CPB)过程中对血小板的影响?方法:选取行CPB下瓣膜置换手术的风湿性心脏病患者24例,随机分成实验组(PGE1干预组)和空白对照组,每组12例?用放射-免疫法分别检测肝素化后(T1)?CPB 30 min(T2)?CPB结束时(T3)和结束后1 h(T4)动脉血中的血栓烷B2(TXB2)?6-酮-前列腺素F1α(6-K-PGF1α)的浓度,并用透射电镜观察T1,T2,T3时血小板超微结构的变化?结果:2组中TXB2?6-K-PGF1α在T2?T3时均较T1时明显升高(P < 0.01),T3时达到最高,T4时恢复至CPB前水平?在T2?T3时6-K-PGF1α实验组明显高于对照组(P < 0.01),而TXB2及二者比值TXB2/6-K-PGF1α则明显低于对照组(P < 0.01)?电镜观察中,对照组未活化(圆型和展平型)的血小板在CPB中均较实验组明显减少,而活化(聚集型和树突型)的血小板明显较实验组增加(P < 0.01)?结论:PGE1能抑制CPB引起的血小板活化,保护血小板功能,降低血小板损耗,减轻凝血功能紊乱,减少术后血液丢失?
英文摘要:
      Objective:To study the protective effect of prostaglandin E1(PGE1) on platelet during cardiopulmonary bypass(CPB).Methods:A total of 24 patients with rheumatic heart disease undergoing cardiac valve replacement were randomly divided into the experimental group(n = 12) and the control group(n = 12). The levels of TXB2 and 6-K-PGF1α in serum were measured at different intervals during and after CPB. The ultrastructure of platelets were also observed with transmission electron microscope. Results:The levels of TXB2 and 6-K-PGF1α during CPB were significantly higher than those before CPB in both groups(P < 0.01), and reached the highest at the end of CPB,then retrieved as before CPB. During CPB,the level of 6-K-PGF1α in the experimental group was significantly higher than that in the control group,while TXB2/6-K-PGF1α and the level of TXB2 were significantly lower than those in the control group(P < 0.01). Meanwhile,the number of unactivated platelets in the control group decreased more obviously than those in the experimental group during the CPB,while the number of activated ones increased(P < 0.01). Conclusion:PGE1 could effectively inhibit the activation of the platelets,protect their function and decrease their loss during the CPB,then reduce the coagulopathy resulted by CPB,reduce the amount of postoperative bleeding.
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