预防性应用四甲基吡嗪改善体外循环中血小板的活化研究

The preventive measures of using tetramethylpyrazine to restrain platelet activation in cardiopulmonary bypass

目的 研究体外循环下心脏手术中血小板功能的改变 ,及四甲基吡嗪在预防血小板活化中可能的作用。方法 将犬随机分成对照组 (A组 )和四甲基吡嗪组 (B组 ) ,每组各 10只 ,常规建立体外循环 ,分别采取围手术期体外循环中的 10个时段来测定血小板数量、代谢产物 ,活化标志蛋白和超微结构的变化。结果 在整个转流期间血小板数量B组明显高于A组 (P <0 .0 1) ;而TXB2 、6 Keto PGF1α,血小板表面GMP 14 0的表达B组低于A组 ( P <0 .0 5 ) ;电镜表现A组转流中血小板伪足增多 ,破碎 ,微管扩张明显 ;而B组的细胞形态改变明显轻于A组 ,转流结束后 ,A组仍可见明显的上述改变 ,而B组能较快地恢复正常。结论 体外循环会造成血小板的活化 ,四甲基吡嗪对这种活化具有一定的抑制作用 ,效果确切 ,副作用少 ,在临床体外循环中可能具有一定的应用价值。

Objective This study was designed to investigate platelet activation and the action of tetramethylpyrazine on this activation in cardiopulmonary bypass(CPB).Methods 20 dogs were divided randomly into two groups:the control group(group A) and tetramethylpyrazine group(group B).Every animal was set up CPB and detected the change of platelets` number?metabolite?marker protein GMP-140 and ultrastructure on ten setting segment.Results:On the duration of bypass,in group B,the number of platelets were more than group A(P<0.01),but the quantity of plasma TXB 2?6-Keto-PGF 1α,and the expression of GMP-140 on platelet surface was less than group A(P<0.05);the histological changes of electron microscope,such as the number of crushed platelets?the degree of enlarged microtubeles and increased pseudopodium were more lightly than in group A.After 2 h of CPB,above-mentioned changes also could be detected in group A,but in group B,some lesion had been recovered on the same time.Conclusions Tetramethylpyrazine can restrain platelet activation in cardiopulmonary bypass.This drug is safe and maybe worth using in clinical CPB.