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冷血停搏液中 RBC 变形能力和携氧能力的变化。

Changes in RBC deformability and oxygen-delivering ability in cold blood cardioplegia.

机构信息

Thoracic and Cardiovascular Surgery, Korea University Medical School, Seoul, Korea.

出版信息

Clin Hemorheol Microcirc. 2011;48(4):223-9. doi: 10.3233/CH-2011-1413.

Abstract

PURPOSE

The advantages of blood cardioplegia, which is used for myocardial protection during open heart surgeries, include superior oxygen-carrying capacities, better osmotic properties, and the presence of more antioxidants than a crystalloid counterpart. Although, hyperkalemic organ-preserving solutions for transplantation surgeries are known to decrease RBC deformability essential for tissue perfusion, only few studies have addressed the changes in RBC deformability after exposure to cardioplegic additives. The purpose of this study was to measure deformability and oxygen-delivery capacities in various blood cardioplegic solutions.

METHODS

Blood from eight healthy volunteers was used. Each sample (100 ml) was divided into 5 groups of 16 ml, and cardioplegia solutions were added (group NS; blood + normal saline, group K; blood + KCl, group D; blood + KCl + diltiazem, group A: blood + KCl + adenosine, group E: blood + KCl + neutrophil elastase inhibitor [Sivelestat]). All samples were incubated at a temperature of 8°C for 10 minutes. Deformability, NO level, 2,3-DPG, and ATP were measured.

RESULTS

There was no statistically significant difference (p = 0.92) in deformability between the groups. The NO levels were not significantly different (p = 0.86). The 2,3-DPG (p = 0.27) and ATP levels (p = 0.40) were not significantly different.

CONCLUSIONS

The deformability and oxygen carrying functions of RBCs did not show a significant difference according to various components of cold blood cardioplegia during 10 minutes of incubation.

摘要

目的

与晶体型心脏停搏液相比,含血心脏停搏液在心脏直视手术中心肌保护的优势在于其具有更高的携氧能力、更好的渗透特性和更多的抗氧化剂。虽然用于移植手术的高钾器官保存液已知会降低组织灌注所需的红细胞变形性,但只有少数研究探讨了暴露于心脏停搏液添加剂后红细胞变形性的变化。本研究旨在测量各种含血心脏停搏液的变形性和携氧能力。

方法

使用 8 名健康志愿者的血液。每个样本(100ml)分为 5 组,每组 16ml,并添加心脏停搏液(NS 组:血液+生理盐水;K 组:血液+KCl;D 组:血液+KCl+地尔硫卓;A 组:血液+KCl+腺苷;E 组:血液+KCl+中性粒细胞弹性蛋白酶抑制剂[Sivelestat])。所有样本在 8°C 的温度下孵育 10 分钟。测量变形性、NO 水平、2,3-DPG 和 ATP。

结果

各组之间的变形性无统计学差异(p=0.92)。NO 水平无显著差异(p=0.86)。2,3-DPG(p=0.27)和 ATP 水平(p=0.40)无显著差异。

结论

在 10 分钟孵育期间,不同成分的冷血心脏停搏液对 RBC 的变形性和携氧功能没有显著影响。

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