前列腺素E_1脂微球载体制剂对体外循环中患者凝血机能的影响

Effect of Lipo-PGE_1 on blood clotting functionduring cardiopulmonary bypass

目的探讨前列腺素E1脂微球载体制剂(L ipo-PGE1)对体外循环(CPB)中患者凝血机能的影响。方法将20例心脏瓣膜置换术患者随机分为观察组及对照组各10例。观察组于麻醉诱导后至CPB结束匀速[3ng/(kg.m in)]泵入L ipo-PGE 1,预充液中加入5ng/m l;对照组用等容量生理盐水。测定围CPB期肝素化后(T1)、CPB开始30m in(T2)及停机即刻(T3)、1h(T4)、24h(T5)五个时点两组血浆TXB2、6-K-PGF1α浓度。结果TXB2、6-K-PGF1α及其比值在CPB过程中显著升高,停CPB时达峰值(P<0.01),24h后恢复至术前水平。在相应时点,观察组6-K-PGF1α明显高于对照组,TXB2及TXB2/6-K-PGF1α明显低于对照组,P均<0.01。结论CPB中患者凝血机能紊乱;L ipo-PGE1能部分纠正凝血功能紊乱。

Objective： To observe the effect of Lipo-PGE1 on blood clotting funetion during cardiopulmonary bypass. Method： 20 patients received cardiac valve replacement undergoing cardiopulmonary bypass （CPB） were divided randomly into two groups; control group and observed group. In observed group, patients were administered 3ng/（kg · min） of Lipo-PGE： and Lipo-PGE1 was added to the priming solution （5ng/ml） of the extraeorporeal circulation machine. In control group, patients were administered the same volume of normal saline. The level of TXB2,6-K-PGF1a. in plasma were measured five times around CPB. Results： The level of TXB2, 6-K-PGF1a, in plasma were all obviously increasing in CPB. The highest level was observed when CPB stopped （P〈0. 01）. The plasma 6-K-PGF1a level in observed group was significantly higher than that in control group at the same time, while TXB2 and TXBJ6-K-PGF1a, were significantly lower than those in control group. Conclusion： There is eoagulopathy in CPB and the Lipo-PGE1 can reclaim it.