Yamaguchi H, Shimizu T, Akutsu H, Kawachi K, Osada K, Fujikawa T, Suesada H, Hirayama T, Ishimaru S, Furukawa K
Department of Surgery, Tokyo Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Apr;38(4):625-9.
Prevention of hemolysis which is related to renal failure during cardiopulmonary bypass (CPB) is very important. We discussed the relationship between hemolysis and red cell deformability during CPB, and moreover the effect of PGE1 to reduce hemolysis. PGE1 was given during CPB (10 approximately 20 ng/kg/min). Red cell deformability was measured using 20% Ht red cell suspension and Nucleopore Microfilter (pore size: 5 mu). Red cell filtration rate (RFR: microliter/sec) was calculated as a value of red cell deformability. Red cell deformability (RFR: microliter/sec) was reduced during CPB in almost all patients. Secondly, plasma Hb (mg/dl) was measured in the controls (n = 8) and PGE1 group (n = 12). The mean pre-bypass level were 20.6 in the control group and 23.8 in the PGE1 group. The mean values of plasma Hb at 30, 60, 90 and 120 min of CPB were 37.8, 52.4, 52.3 and 61.2 in the control group and 24.1, 25.0, 26.3 and 29.0 in the PGE1 group. Our study showed conclusively that CPB has a detrimental effect on red cell deformability and that this effect is accentuated by prolongation of CPB time. PGE1 lessened the decrease in red cell deformability during CPB and was shown to be very effective for prevention of hemolysis.
预防体外循环（CPB）期间与肾衰竭相关的溶血非常重要。我们讨论了CPB期间溶血与红细胞变形性之间的关系，此外还探讨了前列腺素E1（PGE1）减少溶血的作用。在CPB期间给予PGE1（10至20 ng/kg/分钟）。使用20%血细胞比容（Ht）的红细胞悬液和核孔微滤器（孔径：5微米）测量红细胞变形性。红细胞滤过率（RFR：微升/秒）作为红细胞变形性的值进行计算。几乎所有患者在CPB期间红细胞变形性（RFR：微升/秒）均降低。其次，在对照组（n = 8）和PGE1组（n = 12）中测量血浆血红蛋白（mg/dl）。体外循环前对照组的平均水平为20.6，PGE1组为23.8。CPB 30、60、90和120分钟时对照组血浆血红蛋白的平均值分别为37.8、52.4、52.3和61.2，PGE1组分别为24.1、25.0、26.3和29.0。我们的研究确凿地表明，CPB对红细胞变形性有不利影响，并且这种影响会因CPB时间的延长而加剧。PGE1减轻了CPB期间红细胞变形性的降低，并被证明对预防溶血非常有效。
