体外循环转流温度对纤溶系统的影响

Effects of temperature on fibrinolytic response during cardiopulmonary bypass

目的：探讨常温和低温转流对纤溶系统的影响。方法：选取室间隔缺损和法乐氏四联症患儿各15例，分别在常温和中低温（28～30℃）转流下进行手术。于麻醉后，转流开始前（肝素化后），转流10min，转流结束及术后2、20和44h测量组织型纤溶酶原激活剂（t—PA）和纤溶酶原激活物抑制剂（PAI）浓度。结果：转流过程两组t—PAPAI都显著升高，术20h，常温组已恢复至基础水平，而低温组仍明显升高，两组存在显著性差异（P〈0．05）。结论：虽然转流过程中不同温度对纤溶系统影响相似，但是常温转流患者术后恢复快，提示常温转流有助于术后纤溶系统的恢复。

Objective： To detect the effects of normothermie and hypothermie cardiopulmonary bypass （CPB） on fibrinolytic response. Methods： Fifteen patients with ventricular septum defect and 15 patients with tetralogy of Fallot were divided into two groups, who were underwent operations with normothermie or moderate hypothermie 28 30℃ CPB. The blood samples were collected post-anesthesia pre-CPB （after heparinization）, CPB 10 min, termination of CFB, and postoperative 2, 20, and 44 hours and measured concentration of tissue-type plasminogen activator （t-PA）and plasminogen activator, inhibitor （PAI）. Results： Both groups T-PA and PAI significantly increased during CPB. In normothermia group, they returned to baseline postoperative 20 hours, whereas still maintained in high level in hyperthermie group （P〈0. 05）. Conclusion： During CPB, the temperature has no significant effects on fibrinolytie protein. However, it reeoverecL more quickly in normothermia group postoperatively. It suggests that normothermie CPB may be helpful to recovery of the fibrinolytie response post-CPB.