体外循环中肝素、鱼精蛋白对血小板的激活及抑肽酶的抑制作用

目的研究在体外循环中肝素化及鱼精蛋白中和时血小板的激活以及应用抑肽酶对这种激活的抑制作用。方法２０例心脏瓣膜置换术患者随机等分为两组：对照组和抑肽酶组，分别于肝素化及应用鱼精蛋白前后检测血小板胞浆游离钙浓度，磷脂酶Ａ２活性及血浆血栓素水平。结果上述指标在肝素化及鱼精蛋白中和后均显著升高，其中鱼精蛋白中和时升高幅度更大，应用抑肽酶对肝素及鱼精蛋白所引起的上述改变均有显著抑制作用。结论抑肽酶对肝素和鱼精蛋白所致的血小板激活有显著抑制作用，这可能与抑肽酶在体外循环中的止血作用有关。

Activation of Blood Platelets by Heparin and Protamine and Its Inhibition by Aprotinin During Cardiopulmonary Bypass

Objective To study platelet activation by heparin and protamine and its inhibition by aprotinin during cardiopulmonary bypass. Methods 20 patients for cardiac valve replacement operations were randomly divided into two groups: Contral and aprotinin group, platelet plasmic free Ca 2 ]i, the activity of phospholipase A 2 and plasmic thromboxane A 2 levels were measured before and after hearinization and the neutralization of protamine. Results All parameters increased significantly after heparinization and protamine infusion, but these changes after protamine infusion were more significant. All increases were significantly inhibited when aprotinin was given. Conclusion Aprotinin inhibits the activation of blood platelets by heparin and protamine, which may be an important aspect of the effect of aprotinin during cardiopulmonary bypass.