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体外循环期间血小板聚集的变化:聚-2-甲氧基丙烯酸乙酯与肝素作为体外循环管道涂层材料的比较

Changes in platelet aggregation during cardiopulmonary bypass: comparison of poly-2-methoxyethylacrylate and heparin as a circuit coating material.

作者信息

Izuha Hitoshi, Hattori Momoe, Igari Tsuguo, Wakamatsu Daiki, Watanabe Mdtoshiki, Yokoyama Hitoshi

机构信息

Division of Surgery, Fukushima Medical University Hospital, 1-Hikarigaoka, Fukushima, 960-1295, Japan.

出版信息

J Artif Organs. 2005;8(1):41-6. doi: 10.1007/s10047-004-0280-x.

Abstract

At present, there are various biomaterials that have high biocompatibility. In particular, there are many types of coated circuits in cardiopulmonary bypass (CPB) systems. However, only a few clinical studies have investigated platelet aggregation caused by these coated circuits. In this study, a CPB system coated with poly-2-methoxyethylacrylate (X coating) was used to ascertain whether platelet aggregation could be suppressed during CPB, and a comparison was made between X coating and ordinary (covalently bonded) heparin coating. The subjects were 19 adult patients who were scheduled to undergo valve replacement or valvuloplasty. They were divided into two groups: group X (X coating) and group H (heparin coating). The platelet aggregation threshold index (PATI, grading curve) and beta-thromboglobulin and plalelet factor IV levels were assessed preoperatively (control), 5 min after heparin administration, 10 and 60 min after the start of CPB, and 0 and 2 h after the end of CPB. The results indicated that platelet aggregation was reduced during CPB and that platelets were activated. The changes in platelet aggregation associated with the X coating were shown to be similar to those associated with heparin coating.

摘要

目前,有多种具有高生物相容性的生物材料。特别是,体外循环(CPB)系统中有许多类型的涂层回路。然而,只有少数临床研究调查了这些涂层回路引起的血小板聚集。在本研究中,使用涂有聚-2-甲氧基乙基丙烯酸酯(X涂层)的CPB系统来确定在CPB期间血小板聚集是否可以被抑制,并对X涂层和普通(共价结合)肝素涂层进行了比较。研究对象为19名计划接受瓣膜置换或瓣膜成形术的成年患者。他们被分为两组:X组(X涂层)和H组(肝素涂层)。在术前(对照)、肝素给药后5分钟、CPB开始后10分钟和60分钟以及CPB结束后0小时和2小时评估血小板聚集阈值指数(PATI,分级曲线)以及β-血小板球蛋白和血小板因子IV水平。结果表明,CPB期间血小板聚集减少且血小板被激活。与X涂层相关的血小板聚集变化与肝素涂层相关的变化相似。

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