体外循环时凝血叩恶烷A_2的变化

Change of plasma thromboxane A_2 during the cardiopulmonary bypass.

目的 研究本外循环 (CPB)时凝血叩恶烷A2 (血栓素A2 ,TXA2 )的变化。方法 2 0例非紫绀型先天性心脏病患者 ,在CPB开始 5分钟 ,主动脉开放即刻 ,主动脉开放后 5分钟、10分钟、2 0分钟及停CPB时分别行动脉血和静脉血白细胞计数及TXA2 含量测定。结果 ①主动脉开放后 5分钟、10分钟 ,动脉血白细胞计数显著低于静脉血 (P <0 0 5) ,主动脉开放前、主动脉开放后 2 0分钟、停CPB时 ,两者无显著差异。②TXA2于主动脉开放后开始升高 ,10分钟达峰值 ,后逐渐下降 ,但停CPB时仍高于术前 (P <0 0 5) ;动脉血TXA2 含量于主动脉开放后果 5分钟、10分钟均显著高于静脉血 (P <0 0 5)。结论 ①肺脏是CPB期间TXA2 的主要来源之一 ,可能与肺脏大量白细胞隔离有关。②显著升高的TXA2 可能与CPB肺脏损伤及术后右心功能障碍有关。

Objective To investigate the change of plasma thromboxane A 2(TXA 2)during cardiopulmonary bypass.Methods Thromboxane A 2(TXA 2)and leukoecyte were determined in 20 patients with congenital heart disease.The blood samples were collected following cardiopulmonary bypass(CPB),aorta and at the end of CPB.Results ①The arterial leukocyte was significantly lower than the venous when 5 min 10 min after aorta opening( P <0 05).②The arterial TXA 2 concentration was significantly higher than the venous when 5 min after aorta opening.The arterial TXA 2 value peaked at 10 min after aorta openging.It was still higher than preoperation at the end of CPB( P <0.05).Conclusions ①The lung was one ofthe major sources of TXA 2.②The leukocyte sequestered in the lung during CPB.