乌司他丁对体外循环中红细胞的保护作用探讨

目的研究体外循环对红细胞的损伤机制及乌司他丁对体外循环中红细胞的保护作用。方法外循环下行房室缺修补病人20例(CPB时间为30min左右),随机分为乌司他丁组(A组) 和对照组(B组),每组10人。观察两组病人不同时点的游离血红蛋白(FHb)、丙二醛(MDA),红细胞内钙、红细胞C3b受体花环率(RBC-C3bRR)、红细胞免疫复合物花环率(RBC-ICR)。结果(1) MDA、FHb、RBC-ICR、红细胞内钙:转机前,A、B组间无差异,两组转机30分钟后的各次标本含量均明显高于转机前,转机30分钟后A组含量又明显低于B组,组间差异有显著性。(2)RBC-3bRR:转机前两组RBC-C3bRR无明显差异,转机30分钟后两组RBC-C3bRR均明显低于转机前。但转机30 分钟后A组RBC-C3bRR又明显高于B组,组间差异有显著性。结论CPB可导致红细胞损伤及免疫功能下降。体外循环中加入乌司他丁可抑制体外循环中的炎症反应、减轻红细胞内钙离子超负荷,对体外循环中红细胞损伤有较好的保护作用。

The protective effect of ulinastatin on red blood cell in patient during cardiopulmonary bypass

Objective To study the destruction of red blood cell with cardiopulmonary bypass (CPB) and the protective effect of ulinastatin on red blood cell membrane. Methods 20 patients under CPB about 30 minutes were randomly divided into ulinastatin group and control group. Ulinastatin 10000u/kg was added to the patients of ulinastatin group. Plasma levels of malondialdehyde(MDA), free hemoglobin(FHb).the erythrocytes calcium content (E-Ca2 ) , immune erythrocyte C3b receptor garland rate(RBC-C3b RR) were measured before extracorporeal circulation, 30 and 60 minutes after beginning of cardiopulmonary bypass, and on first day morning after operatioa Results (1) MDA. FHb.RBC-ICR,Erythrocytes Calcium levels; levels of those in both groups increased significant after CPB, but those of group A were lower than those of group B at all periods after beginning of CPB,. (2)RBC-C3b RR: levels of those in both groups decreased significantly after CPB , but those of group A were higher than those of group B at all periods after beginning of CPB. Conclusion ulinastatin may protect red blood cell membrane and immunity of patient during extracorporeal circulation.