摘要
目的：探讨体外循环（ＣＰＢ）中纤维蛋白（原）溶解系统的改变情况，为ＣＰＢ中抗纤维蛋白溶解治疗提供理论依据。方法：１２例心脏瓣膜替换术患者，分别于麻醉后手术前５分钟、ＣＰＢ开始后３分钟及１小时、鱼精蛋白拮抗肝素后１０分钟和手术结束后２小时，从颈内静脉采血测定血浆组织型纤溶酶原激活物（ｔ－ＰＡ）活性，纤溶酶原激活物抑制物活性（ＰＡＩ），血浆α２－纤溶酶抑制物（α２－ＰＩ）活性，血浆纤维蛋白原浓度，血浆Ｄ－二聚体（Ｄ－Ｄｉｍｅｒ）及血清纤维蛋白（原）降解产物（ＦＤＰ）浓度。结果：与麻醉后手术前５分钟比较，转机中血浆组织型纤溶酶原激活物活性显著增高（Ｐ＜０．０１），血浆纤溶酶原激活物抑制剂活性显著下降（Ｐ＜０．０１），血浆α２－纤溶酶抑制物活性显著降低（Ｐ＜０．０１），血浆纤维蛋白浓度显著降低（转机后３分钟及１小时分别为Ｐ＜０．０１，Ｐ＜０．０５），Ｄ－二聚体浓度增高（转机后１小时，Ｐ＜０．０５）；术后２小时血浆组织型纤溶酶原激活物活性、血浆纤维蛋白浓度无改变，血浆纤溶酶原激活物抑制剂活性显著增高（Ｐ＜０．００１），α２－纤溶酶抑制物活性仍低于基础值（Ｐ＜０．０５），而血清纤维蛋白（原）降解产物及Ｄ－二聚体浓度显著?
Objective:To investigate the changes in the fibrinolytic system in open heart surgery. Methods:The influence of cardiopulmonary bypass(CPB)on fibrinolytic activity was assessed in 12 patients with valvular heart disease.Tissue type plasminogen activator(t PA) activity,plasminogen activator inhibitor(PAI) activity,α 2 plasmin inhibitor(α 2 PI),fibrinogen(Fib),fibrinogen degradation products(FDP)and D Dimer were measured before,during,and after CPB. Results:There were significant increase in t PA( p <0 01) activity and D Dimer( p <0 05),decrease in Fib( p <0 05),α 2 PI( p <0 01)and PAI( p <0 01) during CPB.The t PA activity and Fib decrease to normal 2 hours after operation,whereas PAI activity showed a marked increase( p <0 001),FDP and D Dimer levels were significantly increased after operation( p <0 05 and p <0 01,respectively). Conclusion:This study shows that there is an activation of the fibrinolytic system during CPB and an increase of fibrinogen degradation product after CPB,thus interferes blood coagulation.
出处
《中国循环杂志》
CSCD
北大核心
1997年第2期84-87,共4页
Chinese Circulation Journal
基金
中华人民共和国卫生部资助
