Rość Danuta, Ogorzeja Wojciech, Kotschy Maria, Missima Maurycy, Jurkowski Piotr
Katedra i Zakład Patofizjologii AM im. Ludwika Rydygiera, Bydgoszczy.
Pol Arch Med Wewn. 2004 Nov;112(5):1297-302.
The participation of disturbances of the vascular endothelial function in the pathogenesis of post perfusion syndrome is controversial.
The aim of the study was the evaluation of the parameters of vascular endothelial injury in the blood plasma of patients undergoing surgery with extracorporeal circulation.
The study was performed in the group of 32 patients (M/F 23/9) with ischaemic heart disease, undergoing coronary artery bypass with extracorporeal circulation. In the blood plasma obtained in the couple of time points in the perioperative period the determinations were done as followed: the concentrations of von Willebrand factor antigen (vWf Ag), tissue plasminogen activator antigen (t-PA Ag), antigen of plasminogen activator inhibitor type 1 (PAI-1 Ag) and fibrinogen. The control group consisted of 29 healthy volunteers sex and age matched.
In blood of patients suffering from ischaemic heart disease before surgery the increased concentrations of vWF Ag, t-PA Ag and fibrinogen were observed. The concentrations of t-PA Ag and vWf Ag hesitated in the perioperative period but always were significantly higher than observed in the control group.
(1) In the blood of patients suffering from the ischemic heart disease undergoing bypass surgery with an extracorporeal circulation the increased concentrations of t-PA Ag and vWf Ag were observed what is the evidence of stimulation/ damage of the vascular endothelium. (2) High levels of t-PA and vWf is seemed to be connected with injury of vessels during coronary artery bypass.
血管内皮功能紊乱在灌注后综合征发病机制中的作用存在争议。
本研究旨在评估体外循环手术患者血浆中血管内皮损伤参数。
本研究纳入32例缺血性心脏病患者(男23例,女9例),行体外循环冠状动脉搭桥术。在围手术期的几个时间点采集血浆,进行如下测定:血管性血友病因子抗原(vWf Ag)、组织型纤溶酶原激活物抗原(t-PA Ag)、1型纤溶酶原激活物抑制剂抗原(PAI-1 Ag)和纤维蛋白原的浓度。对照组由29名年龄和性别匹配的健康志愿者组成。
缺血性心脏病患者术前血浆中vWF Ag、t-PA Ag和纤维蛋白原浓度升高。围手术期t-PA Ag和vWf Ag浓度有所波动,但始终显著高于对照组。
(1)在接受体外循环搭桥手术的缺血性心脏病患者血液中,观察到t-PA Ag和vWf Ag浓度升高,这是血管内皮受到刺激/损伤的证据。(2)高水平的t-PA和vWf似乎与冠状动脉搭桥术中血管损伤有关。