异丙酚对人类血小板聚集的影响

The Effect of Propofol on Human Platelet Aggregation

目的 研究异丙酚应用于全凭静脉麻醉对血小板聚集功能的影响。方法 选择 10例拟行乳腺肿物切除术 (切口小、出血少 )的病人 ,均为女性 ,ASAⅠ级 ,凝血功能正常 ,术前均未服用影响血小板功能的药物。病人术前 30min肌注阿托品0 .5mg和安定 10mg。麻醉诱导静注异丙酚 (2mg·kg-1)和维库溴铵 (0 .1mg·kg-1)后进行气管插管。麻醉维持 :以 5～ 8mg·kg-1·h-1的速度静脉输入异丙酚 ,同时给予适当剂量的维库溴铵和芬太尼。围术期不使用吸入麻醉剂。在麻醉诱导前、注射异丙酚 10min后和 2h后从肘静脉采集血液标本 4mL ,留测血小板聚集功能及PT、APTT。采用比浊法在血小板聚集仪上测定血小板聚集率 ,用ADP诱导血小板的聚集。结果 与麻醉前相比 ,血小板聚集功能在给药 10min后 ,受到显著抑制 ;在给药 2h后 ,又恢复至麻醉前水平。各时点的PT、APTT没有显著变化。结论 异丙酚可抑制血小板的聚集功能 ,但不抑制机体的凝血机制。

Objective To investigate the effect of propofol in total intravenous anesthesia on human ptatelet aggregation.Methods Ten ASAⅠ patients (all female) undergoing adenmammectomy (small incision, less bleeding) were studied. They were all with normal coagulation, and didn't take any drug affecting platelet before operation. 0.5mg atropine and 10mg diazepam were injected intramuscularly 30min before the operation. Tracheal intubation was done after anesthetic induction of intravenous injected 2mg·kg -1 propofol and 0.1mg·kg -1 vecuronium. Maintenance of anesthesia: propofol was given intravenously at speed of 5～8mg·kg·h -1,meanwhile a proper amount of vecuronium and fentanyl were given. No use ofinhalation anesthetic during the perioperation. 4ml blood sample were collected respectively from the anconal vein before anesthesia induction, 10minutes and 2h after the injection of propofol for testing the function of platelet aggregation, PT and APTT. The turbidimetry was used to measure the rate of platelet aggregation on the platelet aggregation device. ADP was used to induce the aggregation of platelet.Results The function of platelet aggregation was depressed 10 minutes after injection than the pre-anesthetic situation; 2h later, the function returned to the level of pre-anesthesia. PT, APTT at every time moment has no obvious change.Conclusions Propofol has inhibitory effect on human platelet aggregation, but has no depression to the coagulation.