丙酮酸钠林格氏液对CPB患者红细胞变形功能的影响：体外实验

Effects of pyruvate Ringer＇s solution on erythrocyte deformation function in patients undergoing cardiopulmonary bypass in vitro

目的 评价丙酮酸钠林格氏液对体外循环（CPB）患者红细胞变形功能的影响.方法 择期CPB下行心脏瓣膜置换术患者13例,年龄25 ～ 64岁,性别不限,ASA分级和NYHA分级Ⅱ或Ⅲ级.分别于CPB 10 min（T1）、60 min （T2）和CPB结束后60 min （T3）时采集桡动脉血样18 ml,将每例患者血样平均分为6份,每份3ml,按照随机配伍设计的原则,分为3组（n=13）：对照组（C组）、乳酸钠林格氏液组（R组）和丙酮酸钠林格氏液组（P组）,各加入生理盐水、乳酸钠林格氏液和丙酮酸钠林格氏液1 ml,在37℃下分别于孵育30、60 min时测定红细胞刚性指数（ERI）和红细胞变形指数（EDI）.结果 与C组和R组比较,P组T1时孵育30、60 min时ERI降低,T1,2时P组孵育30 min时EDI降低（P＜0.05）;T2,3时ERI差异无统计学意义,T3时EDI差异无统计学意义（P＞0.05）;组内孵育不同时点ERI和EDI差异无统计学意义（P＞0.05）.结论 丙酮酸钠林格氏液可增强CPB患者红细胞变形功能.

Objective To evaluate the effects of pyruvate Ringer＇ s solution on erythrocyte deformation function in the patients undergoing cardiopulmonary bypass （CPB） in vitro.Methods Thirteen patients of both sexes,aged 25-64 yr,of ASA physical status Ⅱ or Ⅲ （NAHY Ⅱ or Ⅲ）,scheduled for elective cardiac valve replacement under CPB were enrolled in the study.At 10 and 60 min of CPB （T1,2） and 60 min after termination of CPB （T3）,blood samples 18 ml were drawn from the radial artery and each patient＇s blood sample was equally divided into 6 parts （3 ml per part）.The blood samples were divided into 3 groups （n =13 each）：control group （group C）,lactated Ringer＇s solution group （group R）,and pyruvate Ringer＇s solution group （group P）.In C,R and P groups,normal saline 1 ml,lactated Ringer＇s solution 1 ml,and pyruvate Ringer＇s solution 1 ml were added,respectively,and then the erythrocytes were incubated for 60 min at 37 ℃.At 30 and 60 min of incubation,the erythrocyte rigidity index （ERI） and erythrocyte deformation index （EDI） were detected.Results Compared with C and R groups,the ERI was significantly decreased at 30 and 60 min of incubation at T1,the EDI was decreased at 30 min of incubation at T1,2,and no significant change was found in ERI at T2,3 or in EDI at T3 in group P.There was no significant difference in ERI and EDI at different time points of incubation within groups.Conclusion Pyruvate Ringer＇s solution can enhance erythrocyte deformation function in the patients undergoing CPB.