Mitlyng Benjamin L, Chandrashekhar Yellapragada, Furne Julie K, Levitt Michael D
VA Medical Center, One Veterans Drive, Minneapolis, Minnesota, USA.
Am J Cardiol. 2006 May 1;97(9):1374-6. doi: 10.1016/j.amjcard.2005.11.074. Epub 2006 Mar 20.
First-generation prosthetic heart valves commonly caused sufficient red blood cell (RBC) injury to induce hemolytic anemia. Although multiple studies have shown that new-generation valves are not associated with anemia, the extent to which these valves are injurious to RBCs is not known, because RBC survival not has not been measured in these subjects. Using a technique that uses breath carbon monoxide (CO) to quantify RBC turnover, this study measured RBC life span in 38 subjects with normally functioning, new-generation valves. Erythrocyte survival averaged 98.8 +/- 23 and 103 +/- 15 days, respectively, in 20 subjects with mechanical valves and 18 subjects with bioprosthetic valves (p >0.05). However, these life spans were significantly (p <0.01) less than those of healthy subjects (122 +/- 23 days) and a group of elderly subjects with osteoarthritis (128 +/- 26 days). The mean hemoglobin concentrations of the 2 groups of valve patients were within normal limits. In conclusion, new-generation heart valves commonly are associated with a small degree of hemolysis that is compensated for by increased RBC production.
第一代人工心脏瓣膜通常会对红细胞（RBC）造成足够的损伤，从而引发溶血性贫血。尽管多项研究表明新一代瓣膜与贫血无关，但这些瓣膜对红细胞的损伤程度尚不清楚，因为尚未在这些受试者中测量红细胞的生存期。本研究采用一种利用呼出一氧化碳（CO）来量化红细胞更新率的技术，对38名使用功能正常的新一代瓣膜的受试者的红细胞寿命进行了测量。在20名使用机械瓣膜的受试者和18名使用生物人工瓣膜的受试者中，红细胞生存期平均分别为98.8±23天和103±15天（p>0.05）。然而，这些生存期显著（p<0.01）短于健康受试者（122±23天）和一组患有骨关节炎的老年受试者（128±26天）。两组瓣膜患者的平均血红蛋白浓度均在正常范围内。总之，新一代心脏瓣膜通常与轻度溶血有关，这种溶血可通过红细胞生成增加得到代偿。
