Woods H F, Ash G, Weston M J, Bunting S, Moncada S, Vane J R
Lancet. 1978 Nov 18;2(8099):1075-7. doi: 10.1016/s0140-6736(78)91806-8.
Despite the use of heparin, activation of platelets on the artificial surface of dialyser membranes results in thrombus formation, microembolisation, and thrombocytopenia. To assess the effects on these events of prostacyclin, the most potent inhibitor of platelet aggregation yet discovered, three groups of healthy greyhounds were dialysed with heparin, heparin plus prostacyclin, or prostacyclin alone. Prostacyclin, either alone or with heparin, abolished microembolisation from the dialyser (as estimated by whole-blood screen filtration pressure) and prevented thrombocytopenia. With prostacyclin, dialysis could be carried out without heparin, and there was no clotting of blood within the extracorporeal circuit nor any change in tests of coagulation.
尽管使用了肝素,但透析器膜人工表面上的血小板激活仍会导致血栓形成、微栓塞和血小板减少。为了评估前列环素(迄今发现的最有效的血小板聚集抑制剂)对这些事件的影响,将三组健康的灵缇犬分别用肝素、肝素加前列环素或单独使用前列环素进行透析。单独使用前列环素或与肝素联合使用时,均可消除透析器产生的微栓塞(通过全血筛滤压估算)并预防血小板减少。使用前列环素时,可在不使用肝素的情况下进行透析,体外循环内的血液不会凝固,凝血测试也无任何变化。