摘要
目的探讨前列腺素E1脂微球载体制剂(Lipo-PGE1)对体外循环(CPB)中患者血液系统的影响。方法将20例施行心脏瓣膜置换术患者随机分为观察组和对照组各10例,观察组于CPB开始至结束匀速3 ng/(kg.min)泵入Lipo-PGE1,预充液中加入5 ng/mL,对照组用等容量生理盐水。测定肝素化后(T1)、CPB开始30min(T2)及CPB结束即刻(T3)、CPB结束1h(T4)、CPB结束24 h(T5)5个时点血浆血栓素B2(TXB2)、6-酮-前列腺素F1α(6-Keto-PGF1α)、游离血红蛋白(F-HB)的浓度值。结果两组中TXB2、6-Keto-PGF1α及其比值、F-HB在CPB过程中均显著升高,CPB结束时达峰值,各时点与T1比较差异有统计学意义(P<0.05)。在相应时间点,观察组6-Keto-PGF1α明显高于对照组,TXB2、TXB2/6-Keto-PGF1α、F-HB明显低于对照组(P<0.05)。结论Lipo-PGE1能纠正CPB中TXB2与6-Keto-PGF1α比值的失衡,改善患者的凝血功能;降低血浆中F-HB的浓度,减轻由红细胞破坏引起的机体溶血,对患者的血液系统有一定的保护作用。
Objective To explore the effects of Liposomal Prostaglandin E1 （Lipo-PGE1） on the blood system in patients with cardiopulmonary bypass（CPB）. Methods 20 patients received cardiac valve replacement undergoing CPB were randomly divided into two groups （10 patients in each group） ： the experimental group and the control group. In the experimental group, patients were administered 3 ng/（kg· min） Lipo-PGE1 and Lipo-PGE1 which was added into the priming solution （5 ng/mL） of the extracorporeal circulation machine. In the control group, patients were administered the same volume of normal saline. The levels of thromboxane B2 （TXB2）, 6-keto-Pmstaglandin F1α （6-Keto-PGF1α） and free hemoglobin （F-HB） in the plasma were determined five times around CPB. Results In the two groups, levels of TXB2, 6-Keto-PGF1α and F-HB were all obviously increased in CPB and they reached the highest when CPB stopped. The level of 6-Keto-PGF1α in the experimental group was significantly higher than that in the control group, while levels of TXB2, TXB2/6-Keto-PGF1α and F-HB were significantly lower than those in the control group （ P 〈 0.05）. Conclusion Lipo-PGE1 can reclaim the imbalance of TXA2/PGI2 in CPB and partly improves coagulation disorder and lessens hemolysis caused by CPB, so it can obviously reduce kidney injury.
出处
《山东大学学报（医学版）》
CAS
北大核心
2008年第10期991-993,997,共4页
Journal of Shandong University:Health Sciences
