Nitter-Hauge S
Br Heart J. 1976 Sep;38(9):977-80. doi: 10.1136/hrt.38.9.977.
The present study reports on the incidence and degree of intravascular haemolysis in 33 patients with Björk-Shiley tilting disc prosthesis and in 34 patients with Lillehei-Kaster pivoting disc valve prosthesis in the mitral position examined 12 to 24 months after the operation. Serum haptoglobin, serum lactate dehydrogenase, serum bilirubin, and haemoglobin estimations were performed. Significant haemolysis was detected in 85 per cent of the patients. Haptoglobin was absent or reduced in 72 per cent, while raised values for serum lactate dehydrogenase were found in 43 per cent. The increase in lactate dehydrogenase was moderate and showed no correlation with blood flow through the prosthesis or with the gradient across the prosthesis. Most patients had normal haemoglobin and normal serum bilirubin values. Although intravascular haemolysis was of little clinical significance, the increase in lactate dehyrdrogenase was significantly higher in patients with the Lillehei-Kaster prosthesis than in patients with the Björk Shiley prosthesis, indicating a slightly shorter red cell lifespan in the former group. The possible reasons for the difference between the two groups are discussed.
本研究报告了33例植入比约克-希利倾斜碟瓣假体和34例植入利尔黑-卡斯特旋转碟瓣假体的二尖瓣置换患者在术后12至24个月时血管内溶血的发生率和程度。检测了血清触珠蛋白、血清乳酸脱氢酶、血清胆红素和血红蛋白。85%的患者检测到明显溶血。72%的患者触珠蛋白缺乏或降低，而43%的患者血清乳酸脱氢酶值升高。乳酸脱氢酶的升高幅度适中，与通过假体的血流量或假体两端的压力阶差无关。大多数患者血红蛋白和血清胆红素值正常。虽然血管内溶血的临床意义不大，但植入利尔黑-卡斯特假体的患者乳酸脱氢酶的升高明显高于植入比约克-希利假体的患者，这表明前一组患者红细胞寿命略短。文中讨论了两组之间差异的可能原因。
