先天性心脏病患儿血管内皮生长因子单核苷酸多态性研究

Protective effect of prostaglandin E1 on platelet during cardiopulmonary bypass

目的研究中国汉族人群中血管内皮生长因子VEGF+936C>T多态性与发生先天性心脏病危险的关系。方法以PCR-RFLP技术分析105例先天性心脏病和167例非先天性心脏病患者VEGF基因+936C>T(rs3025039)多态性,比较不同基因型与先天性心脏病发生危险的关系;用ELISA法测定两组对象血浆VEGF浓度。结果VEGF基因+936C>T3种基因型在先天性心脏病组和非先天性心脏病对照组的分布差异不具有显著性,先天性心脏病组血浆VEGF的浓度明显高于对照组。结论VEGF基因+936C>T多态性可能不是中国汉族人群先天性心脏病发生的危险因素,但VEGF增高可能与先天性心脏病某些并发症相关。

Objective To investigate the protective effect of prostaglandin E1 （PGE1） on platelet during cardiopulmonary bypass （ CPB ）. Methods A total of 24 patients undergoing cardiac valve replacement were randomly divided into the experimental group （ n = 12） and the control group （n = 12 ）. The levels of thromboxane B2 （TXB2） and 6-keto-prostaglandin F1α（6-K-PGF1α） in serum were measured at different intervals during and after CPB. The uhrastructure of platelets was also observed by transmission electron microscope. Results The levels of TXB2 and 6-K-PGF1α during CPB were significantly higher than those before CPB in the both groups（ P 〈 0.01 ） ,and reached the highest at the end of CPB, then recovered as those before CPB. During CPB, The level of 6-K-PGF1α in the experimental group was significantly higher than that in the control group, while the ratio of TXB2/6-K-PGF1α and the level of TXB2 were significantly lower than those in the control group （P 〈 0.01 ）. It was found that the numbers of unactivated platelet in the both groups during CPB decreased obviously, while the numbers of activated platelet increased than those before CPB （P 〈 0.01 ）. Conclusions PGE1 could effectively inhibit the activation of platelets, protect the function of platelets and decrease the loss during the CPB, so the coagulopathy caused by CPB relieved, and the amount of postoperative bleeding was consequently reduced.