Muikku O, Kuitunen A, Hynynen M
Department of Anaesthesia, Helsinki University Central Hospital, Finland.
Acta Anaesthesiol Scand. 1995 Jul;39(5):618-23. doi: 10.1111/j.1399-6576.1995.tb04137.x.
Various in vitro, ex vivo and in vivo tests have shown that organic nitrates attenuate platelet function. Because organic nitrates are commonly administered to patients undergoing cardiac surgery, the postoperative bleeding tendency observed in these patients might be strengthened by nitrates. Therefore, we compared the acute effects of nitroglycerin (0.5 micrograms kg-1 min-1) and isosorbide dinitrate (0.5 or 2.5 micrograms kg-1 min-1) with those of placebo on platelet function both before and after cardiopulmonary bypass in 40 patients undergoing coronary artery bypass grafting (CABG). Bleeding time, platelet retention on glass beads, i.e. platelet adhesiveness, and thromboelastograph tracings were used as indicators of platelet function. Although nitroglycerin and isosorbide dinitrate induced significant haemodynamic changes, e.g. decreases in arterial and pulmonary arterial pressure, they had no significant effects on the indices of platelet function. We conclude that, when given in haemodynamically effective doses, neither nitroglycerin nor isosorbide dinitrate have any measurable acute effect on platelet function as evaluated with on-site tests in patients undergoing CABG surgery.
各种体外、离体和体内试验均表明，有机硝酸盐可减弱血小板功能。由于心脏手术患者通常会使用有机硝酸盐，这些患者术后出现的出血倾向可能会因硝酸盐而加剧。因此，我们比较了硝酸甘油（0.5微克/千克·分钟）和硝酸异山梨酯（0.5或2.5微克/千克·分钟）与安慰剂对40例行冠状动脉旁路移植术（CABG）患者体外循环前后血小板功能的急性影响。出血时间、玻璃珠上的血小板滞留率（即血小板黏附性）以及血栓弹力图描记用作血小板功能指标。尽管硝酸甘油和硝酸异山梨酯引起了显著的血流动力学变化，如动脉压和肺动脉压降低，但它们对血小板功能指标无显著影响。我们得出结论，在接受CABG手术的患者中，当给予血流动力学有效剂量时，硝酸甘油和硝酸异山梨酯对通过现场试验评估的血小板功能均无任何可测量的急性影响。
