体外循环和非体外循环冠状动脉旁路移植术围术期血小板数量和功能的变化研究

目的分析体外循环和非体外循环冠状动脉旁路移植术（CCABG和OPCAB）围术期血小板数量和功能的变化情况。方法随机选取接受CCABG和OPCAB的患者各30例，术后常规阿司匹林治疗（100mg，每天1次），分别记录两组术前、术后当天、术后1d、5d和10d的血小板数量及二磷酸腺苷诱导的血小板聚集率（PAG）。描绘走行趋势图，分析术后血小板数量和PAG的变化规律。结果在术后常规阿司匹林治疗的情况下，CCABG组和OPCAB组患者术后早期血小板数量均短暂下降，然后显著上升并超过术前水平（P〈0．01），这种变化在CCABG组更明显。两组的PAG术后均增高（P〈0．05），于术后第10天，OPCAB组基本恢复正常，而CCABG组仍高于术前水平（P〈0．05）。结论无论是否应用体外循环，CABG术后均有血小板数量的增加和功能的提高，体外循环组的变化更明显。

Perioperative variation in platelet count and function after off-pump and on-pump coronary artery bypass grafting

Objective To compare the perioperative variation of platelet count and function between off - pump and on - pump coronary artery bypass grafting. Methods Sixty patients who would underwent off - pump coronary artery bypass grafting（ OPCAB, n = 30 ） or conventional coronary artery bypass grafting（CCABG） （CCABG, n = 30 ） ）were randomly selected for this study. Aspirin was routinely administered （ 100 mg once daily）for all the patients after sugery. Platelet function （defined as adenyl diphosphoric acid -induced platelet aggregation, PAG）and platelet count were measured before the operation, on the operation day, and 1,5, and 10 day （s） after the operation. Results In both groups, platelet count was transiently decreased after surgery and then increased markedly （P 〈 0.01 ）. This change in the CCABG group was more obvious than in the OPCAB group. PAG was also increased significantly in both groups （P 〈 0.05 ）. On day 10 ,PAG was recovered in the OPCAB group but was still at a higher level in the CCABG group （ P 〈 0.05 ）. Conclusion Both the count and function of the platelet will increase significantly after CABG procedure. This change is more obvious in patients who were given cardiopulmonary bypass.