体外循环对瓣膜置换术病人红细胞膜功能的影响

Influences of cardiopulmonary bypass on membraneous function of erythrocyte in patients undergoing cardiacvalvular replacement

目的：观察体外循环对红细胞膜的损伤作用。方法：利用ＤＰＨ荧光标记测定１０例瓣膜置换术病人红细胞膜流动性，并测定红细胞膜三磷酸腺苷（ＡＴＰ）酶活性和丙二醛含量。结果：转流３０分红细胞膜平均微粘度（η）、各向异性（γ）和丙二醛均明显增加（Ｐ＜０．０１），而膜上Ｎａ＋，Ｋ＋－ＡＴＰ酶、Ｃａ艹－ＡＴＰ酶和Ｍｇ艹－ＡＴＰ酶活性明显降低（Ｐ＜０．０１）。停机后３０分上述各值仍未恢复到转流前水平。结论：ＣＰＢ可通过引起红细胞膜脂质过氧化反应增强，降低膜流动性和膜上ＡＴＰ酶活性，对红细胞产生损伤。

Objective:To observe the effects of cardiopulmonary bypass on erythrocyte membrane during cardiac valvular replacement.Method:The fluidity of the membrane lablled with 1,6 diphenyl 1,3,5 hexatriene(DPH)was measured by fluorometry,and membraneous adenosinetriphosphatases(ATPase)activities and malondialdyhyde(MDA)content were simutaneously assayed.Result:During CPB 30 mins the microviscosity,anistopy and MDA content increased significantly(P<0.01),and the activities of Na +,K + ATPase,Ca ++ ATPase and Mg ++ ATPase decreased(P<0.01)compared with those before CPB;30mins after CPB,the microviscosity,anistopy and MDA content were higher and the activities of ATPases were lower than those before CPB.Conclusion:CPB might cause the damage to erythrocyte by the enhencement of lipid peroxidation,the decreases of fluidity and ATPases activities in erythrocyte membrane.