Riadovoĭ G V, Grishchenko M N, Tutubalin V N, Khodas M Ia
Vestn Akad Med Nauk SSSR. 1990(12):24-8.
The oxygen transport function of the blood was studied in 223 patients in the early postoperative period after open-heart surgery, which included correction of acquired cardiac valve defects and aortocoronary bypass. The studied parameters comprised central hemodynamics, pulmonary gas exchange, oxygen supply and utilization, acid-base status, blood gas and lactate content, as well as erythrocytic 2,3-diphosphoglycerate (DPG); Boehringer Mannheim reagents (FRG) were used. The venous blood P50 was calculated using a Severinghaus device. It was found, that the Bohr effect and temperature changes are the major factors controlling the Hb affinity to oxygen. No coefficient modifications in pH and T were detected. Patients with cardiac and pulmonary disorders showed, along with the Bohr effect and temperature influences, an additional shift of the oxyhemoglobin dissociation curve. A positive relationship was revealed between the 2,3-DPG level and standard P50 value. However, the coefficient was low (0.010) at 2,3-DPG and insufficiently stable. It is most probable, that 2,3-DPG mediates the buffer effect eliminating the drastic P50 deviations and is not completely responsible for additional ODC shifts in cardiopulmonary disorders. A quantitative relationship between hypoxia and Hb affinity to oxygen was revealed. The coefficient at SO2 Y varied from -0.0025 to -0.0030 by one percent of changes in the latter. Reduction in SO2 by 15 percent in cardiopulmonary patients was equivalent to the Bohr effect at a pH fall by 0.1 unit.
对223例心脏直视手术后早期患者的血液氧运输功能进行了研究，手术包括后天性心脏瓣膜缺损矫正和主动脉冠状动脉搭桥术。研究参数包括中心血流动力学、肺气体交换、氧供应与利用、酸碱状态、血气和乳酸含量，以及红细胞2,3-二磷酸甘油酸（DPG）；使用了德国宝灵曼试剂。采用西弗宁斯装置计算静脉血P50。研究发现，波尔效应和温度变化是控制血红蛋白与氧亲和力的主要因素。未检测到pH值和温度的系数变化。患有心脏和肺部疾病的患者，除了波尔效应和温度影响外，氧合血红蛋白解离曲线还出现了额外的偏移。2,3-DPG水平与标准P50值之间呈正相关。然而，2,3-DPG时的系数较低（0.010）且稳定性不足。最有可能的是，2,3-DPG介导缓冲效应，消除P50的剧烈偏差，且并非完全导致心肺疾病中氧解离曲线的额外偏移。揭示了缺氧与血红蛋白对氧亲和力之间的定量关系。SO2每变化1%，其系数在-0.0025至-0.0030之间变化。心肺疾病患者中SO2降低15%相当于pH值下降0.1单位时的波尔效应。
