心肺转流期间活化血小板含量的变化及临床意义

目的　探讨心肺转流 (CPB)期间血小板活化状态的临床意义。方法　用流式细胞术检测 60例先天性心脏房、室间隔缺损患者在CPB下行心内修补术的血小板表面活化分子P 选择素和凝血酶敏感蛋白的变化。并与试管内试验结果比较。结果　转流中和手术结束时血小板P 选择素和凝血酶敏感蛋白较术前明显增加 (P <0 0 5 ) ,血小板总数较术前明显减少 (P <0 0 5 )。而试管内试验结果与之不符。结论　CPB期间由于血小板破坏增加 ,总数减少 ,血小板表面活化分子P 选择素和凝血酶敏感蛋白代偿性增加 ;但由于血小板总数减少 ,出血倾向仍然明显。

The clinical significance of activated platelets during cardiopulmonary bypass

Objective To evaluate the significance of activated platelets during cardiopulmonary bypass (CPB).Methods The activated P selectin and thrombospodin of platelet surface were measured with flow cytometry in 40 patients with atrial or ventricular septal defect during open heart surgery,which was compared with those in vitro.Results The activated P selectin and thrombospodin were significantly higher than the baselines ( P< 0 05) during CPB,and immediately after operation.Blood platelet count was significantly lower than the baselines ( P< 0 05).The variations of P selectin and thrombospodin in vitro was different from that in vivo.Conclusion Bleeding complications associated with CPB may result from a decrease in platelet counts rather than from the changes in activated P selactin and thrombospodin.