Epstein Danny, Vishnepolsky Andrey, Bolotin Gil, Atweh Nardeen, Bonstein Lilach, Lehavi Amit
Department of Internal Medicine "B," Rambam Health Care Campus, Haifa, Israel.
Department of Anesthesiology, Rambam Health Care Campus, Haifa, Israel.
Thorac Cardiovasc Surg. 2021 Dec;69(8):719-722. doi: 10.1055/s-0040-1721477. Epub 2021 Jan 19.
Cardiopulmonary bypass (CPB) is associated with platelet dysfunction (PD), an important cause of postoperative bleeding. The etiology of PD is not completely understood. We mapped the platelets' function during CPB to determine the etiology of PD. Platelets activation, measured by procaspase activating compound-1 and P-selectin expression (CD62P), after activation by adenosine diphosphate and thrombin receptor activator peptide, were decreased by protamine. Changes during CPB were insignificant. Platelet-leukocyte aggregation was increased by CPB but not by protamine. Platelet apoptosis marker, annexin V, was increased by protamine. Changes during CPB were insignificant. Our findings demonstrate that protamine given after CPB plays a central role in PD and count decrease.
体外循环（CPB）与血小板功能障碍（PD）相关，这是术后出血的一个重要原因。PD的病因尚未完全明确。我们绘制了CPB期间血小板的功能，以确定PD的病因。在二磷酸腺苷和凝血酶受体激活肽激活后，通过半胱天冬酶原激活化合物-1和P-选择素表达（CD62P）测量的血小板活化，被鱼精蛋白降低。CPB期间的变化不显著。CPB增加了血小板-白细胞聚集，但鱼精蛋白没有。血小板凋亡标志物膜联蛋白V被鱼精蛋白增加。CPB期间的变化不显著。我们的研究结果表明，CPB后给予的鱼精蛋白在PD和计数减少中起核心作用。
