尼群地平对体外循环中血小板数量及粘附、聚集功能的影响

EFFECTS OF NITRENDIPINE FOR PLATLET COUNTS AND FUNCTION IN CARDIOPULMONARY BYPASS

４０例先天性心脏病患儿按随机配对原则分为对照组（Ｃ组）与实验组（Ｎ组）。Ｎ组术前７ｄ口服尼群地平０．５ｍｇ·ｋｇ－１／次，１次／８ｈ，最后１次用药于术前２ｈ。测定围体外循环期血小板计数、瑞斯托霉素及ＡＤＰ诱导的最大凝集率。结果表明，Ｎ组血小板计数、瑞斯托霉素诱导的最大凝集率在转流中、后增高于Ｃ组（Ｐ＜０．０５～０．０１），ＡＤＰ诱导的最大聚集率在转流前、中低于Ｃ组，转流后高于Ｃ组（Ｐ＜０．０５～０．０１），术后纵隔引流量明显减少。说明尼群地平能有效地抑制体外循环中血小板活化。

The aim of this study was to determine the platlet protection of calcium channel blockers in cardiopulmonary bypass(CPB).We selected nitrendipine which there is no nagative inotropic and heart rate actions for preventive measure pre CBP.Forty patients with congenital heart disease were studied in two groups.Group N was administered with nitrendipine 0.5mg/kg/dose q8h,7 days preoperation,the last dose at 2 hours preoperation.Group C was control group.The platelet counts,ristocetin induced platelet agglutination and ADP induced platelet aggregation were assayed at 5 different time points peri CPB.The platelet counts and maximum platelet agglutination induced by ristocetin were higer during and after CPB in group N (P less than 0.05 to less than 0.001).The ADP induced platelet aggregation was reduced in group N before and during CPB (P less than 0.05), but it's higher after CPB (P less than 0.05 ).Postoperative chest drainage wes significantlly reduced in group N.In summary, nitrendipine offers inhibiting action to platelet activation during CPB, thus preserving platelet function and hemostasis after CPB.