Böhrer H, Böttiger B W, Haussmann R, Nawroth P P, Motsch J, Martin E
Klinik für Anästhesiologie, Universität Heidelberg.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1995 Nov;30(7):417-9. doi: 10.1055/s-2007-996519.
Thrombomodulin is a high-affinity receptor for thrombin on the endothelial cell surface. The aim of our study was to investigate whether plasma thrombomodulin represents a marker of endothelial injury following cardiopulmonary bypass.
Plasma levels of thrombomodulin were quantitated in 70 plasma samples obtained from 14 adult cardiac patients undergoing hypothermic pulsatile low-flow low-pressure cardiopulmonary bypass. Blood samples were taken before cardiopulmonary bypass (T1), and 15 minutes (T2), 1 hour, 6 hours, and 20 hours after termination of bypass. Plasma thrombomodulin was quantitated with a sandwich enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed by the Friedman and Wilcoxon tests.
Plasma thrombomodulin was significantly elevated 20 hours after discontinuation of cardiopulmonary bypass, when compared with T1 and T2.
We conclude from our results that a moderate elevation of plasma thrombomodulin is seen in adult patients following hypothermic, low-flow low-pressure cardiopulmonary bypass, which may reflect endothelial injury. Circulating thrombomodulin levels are thus possibly useful for assessment of endothelial damage occurring in patients undergoing cardiopulmonary bypass.
血栓调节蛋白是内皮细胞表面凝血酶的高亲和力受体。我们研究的目的是探讨血浆血栓调节蛋白是否代表体外循环后内皮损伤的标志物。
对14例接受低温搏动性低流量低压体外循环的成年心脏病患者的70份血浆样本中的血栓调节蛋白水平进行定量。在体外循环前（T1）、体外循环结束后15分钟（T2）、1小时、6小时和20小时采集血样。采用夹心酶联免疫吸附测定法（ELISA）对血浆血栓调节蛋白进行定量。采用Friedman和Wilcoxon检验进行统计分析。
与T1和T2相比，体外循环停止20小时后血浆血栓调节蛋白显著升高。
我们从结果中得出结论，低温、低流量低压体外循环后的成年患者血浆血栓调节蛋白有适度升高，这可能反映了内皮损伤。因此，循环血栓调节蛋白水平可能有助于评估体外循环患者发生的内皮损伤。
