低温与体外循环对血小板活化作用机制研究

Study on the mechanism of hypothermia and cardiopulmonary bypass on platelet activation

目的探讨低温和体外循环对血小板活化作用的机制。方法取成年健康巴马香猪10只,建立体外循环,分别在体外循环前(T_1),体外循环20 min后维持正常体温(T_2),在T_2基础上将温度降到32℃后20 min(T_3)留取4管静脉血,待检测。然后,在T_1、T_2、T_3中的3管静脉血中分别加入甲醇提取残渣(MER)、甲酯磺酸盐(MES)、MER+MES各100μmol,另1管静脉血为对照组,共分为4组,测量4管血中的P-选择蛋白的含量。结果在对照组中,T_2与T_1比较,P-选择蛋白明显升高(P<0.05),T_3与T_1比较,P-选择蛋白进一步升高(P<0.05)。在T_1中,加入MER、MES、MER+MES后的P-选择蛋白无明显变化(P>0.05)。在T_2中,MER、MES组与对照组比较,P-选择蛋白明显下降(P<0.05);但MER组与MES组间比较,差异无统计学意义(P>0.05);MER+MES组的P-选择蛋白下降的更加显著(P<0.05)。在T_3中,MER、MES组与对照组比较,P-选择蛋白也明显下降(P<0.05);但MER组与MES组间比较,差异无统计学意义(P>0.05);MER+MES组的P-选择蛋白较之前下降地明显(P<0.05)。结论低温和体外循环中血小板的活化是通过ADP诱导的。

Objective To investigate the mechanism of hypothermia and extracorporeal circulation on platelet activation. Methods Adult healthy ten swine,cardiopulmonary bypass was established,respectively,before CPB（ T1）,after 20 minutes of cardiopulmonary bypass to maintain normal body temperature（ T2）,at T2 will be the basis of temperature down to 32℃ after 20 minutes（ T3） stay tube four venous blood for detection. Then in T1,T2,T3 of which 3 of the blood were joined MER（ 100 μmol）,MES（ 100 μmol）,MER ＋ MES（ 100 μmol）,the other group for the control group,it was divided into 4 groups,measuring the content of P-select protein in the blood of 4 tubes. Results In the control group compared with T2 and T1,P-selection protein was significantly higher（ P〈0. 05）,compared with T3 and T1,P-selection protein was further increased（ P〈0. 05）. There was no significant change of P-selection protein in MER ＋MES and MER and MES at T1（ P〉0. 05）. In T2,compared with MER and MES P-selection protein were significantly decreased（ P〈0. 05） compared with the control group,but there was no significant difference between the two（ P〈0. 05）,while P-selection protein of MER ＋ MES decreased more significantly（ P〈0. 05）. In T3,MER and MES compared with the control group,P-select protein also significantly decreased（ P〈0. 05）,but there was no significant difference between the two（ P〉0. 05）,while the P-selection protein of MER ＋ MES decreased significantly（ P〈0. 05）. Conclusion The activation of platelets in hypothermia and in vitro circulation was induced by ADP.