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体外循环对小儿纤溶系统的影响

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摘要 目的观察体外循环(CPB)对小儿纤溶系统的影响,探讨引起纤溶亢进的机制。方法选择行择期手术的先天性心脏病患儿22例,于麻醉诱导后切皮前(T1),肝素化后5min(T2),CPB10min(T3),停CPB(T4),鱼精蛋白中和后10min(T5),术后2h(T6),术后第1天(T7)、术后第2天(T8),采集动脉血检测血浆组织纤溶酶原激活剂(t-PA)和纤溶酶原激活剂抑制物-1(PAI-1)水平。结果t-PA在肝素化后开始升高(P<0.05),转流后迅速升高(P<0.01),且维持在高水平,约为术前10倍。鱼精蛋白中和后下降(P<0.05),术后第2天降低,但仍高于术前(P<0.05)。PAI-1转流后升高(P<0.05)约为术前2倍,术后第2天恢复至术前水平。t-PA/PAI-1比值转流后明显升高(P<0.01),转流中比值约为术前5倍,术后第1天恢复至术前水平。结论体外循环对小儿纤溶系统影响很大,纤溶系统明显激活,其机制与血浆中t-PA升高及t-PA/PAI失衡有密切关系。
出处 《广东医学》 CAS CSCD 北大核心 2007年第7期1113-1114,共2页 Guangdong Medical Journal
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