Kobori M, Hosoyamada A, Satoh N, Kouno S, Gomi K
Department of Anesthesiology, School of Medicine, Showa University, Tokyo.
Masui. 1993 May;42(5):677-82.
We studied the effect of hemodilutional autotransfusion on coagulative-fibrinolytic dynamics and metabolic response. Hemodilutional solutions used were Dextran-40 (group A) and Salin-HES (group B). The activated partial thromboplastin time (APTT) immediately after hemodilution was prolonged in both groups. Prothrombin time (PT) and hepaplastin decreased significantly, and a remarkable variation was observed particularly in group A. The results suggest that effect on fibrinolytic dynamics is not exerted in either group because antithrombin-III (AT-III) and fibrinogen decreased significantly, while fibrinogen degradation products (FDP) are within normal ranges, and plasminogen as well as alpha 2-plasmin inhibitor (alpha 2-PI) decreased significantly. On the other hand, all other parameters such as lactic acid level, pyruvic acid level in blood, lactic acid pyruvic acid ratio, and blood glucose level were elevated during surgery, but no difference was observed regarding these parameters between the two groups.
我们研究了血液稀释性自体输血对凝血-纤溶动力学及代谢反应的影响。所使用的血液稀释溶液为右旋糖酐-40（A组）和生理盐水-羟乙基淀粉（B组）。两组在血液稀释后即刻活化部分凝血活酶时间（APTT）均延长。凝血酶原时间（PT）和肝促凝血酶原激酶明显降低，且在A组尤其观察到显著变化。结果表明，两组均未对纤溶动力学产生影响，因为抗凝血酶-III（AT-III）和纤维蛋白原显著降低，而纤维蛋白原降解产物（FDP）在正常范围内，且纤溶酶原以及α2-纤溶酶抑制剂（α2-PI）也显著降低。另一方面，手术期间所有其他参数如血乳酸水平、丙酮酸水平、乳酸/丙酮酸比值及血糖水平均升高，但两组在这些参数方面未观察到差异。
