体外循环对血小板功能影响的研究

The Effect of Cardiopulmonary Bypass on Platelet Function

选择心脏瓣膜替换术病人１０例，用流式细胞术（ＦＣＭ）方法在围术期定量检测血小板质膜蛋白Ｉｂ、ＩＩｂ／ＩＩａ复合物、血小板α颗粒膜蛋白、溶酶体完整膜蛋白－ＣＤ６３及血小板计数等项血小板膜糖蛋白指标进行统计学处理。结果表明体外循环中血小板计数、膜糖蛋白Ｉｂ均明显下降；α－颗粒膜蛋白１４０、溶酶体完整膜蛋白及膜糖蛋白Ｉｂ／ＩＩａ均显著增高。证实体外循环（ＣＰＢ）对血小板膜糖蛋白的影响，更深入了解ＣＰＢ导致血小板功能获得性损害的分子机制。

Aim:To determine the effect of cardiopulmonary bypass(CPB) on platelet function.Method:10 patients with valvular heart disease were operated on under CPB.Blood samples were taken at 4 different time intervals:before CPB,at 40 minutes after CPB,end of CPB and one hour after surgery,platelet membrane glycoproteins(GPIb,GPIIb/IIIa,GMP-140,LIMP-CD 63 were measured by flow cytometry.Result:There was significant increase in GP IIb/IIIa,GMP-140,LIMP-CD 63 and decrease in GP Ib,platelet count during and after CPB,comparing to their baseline values.Conclusion:Alteration of platelet adhesive receptors may lead to persistent platelet activation during CPB and this may play a role in the pathogenesis of the qualitative platelet defect associated with CPB.