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明胶溶液和右旋糖酐-70对血小板膜糖蛋白Ⅰb/Ⅰx和血管性假性血友病因子的影响

INFLUNCE OF GELATIN AND DEXTRAN ON PLATELET vWF AND Ⅰb/Ⅰx
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摘要 为探讨在硬膜外阻滞下行胆囊切除术的病人术中输注明胶溶液和右旋糖酐 70后对血小板膜糖蛋白Ⅰb /Ⅰx(GPⅠb /Ⅰx )、血管性假性血友病因子 (vWF)和血小板粘附试验 (PAdT)的影响以及相互关系 ,将10 5例病人随机分为 4组 :A组术中输注生理盐水 ;B组输注右旋糖酐 70 ;C组输注尿联明胶 ;D组输注改良明胶。于输注前、输注后 2h、3h采集静脉血 ,分别测定GPⅠb /Ⅰx、vWF及PAdT。结果显示 :B组在输注 3h后vWF明显低于其它 3组 (P <0 0 1) ,B组GPⅠb /Ⅰx输注液体 3h后比输注前也有显著降低 (P <0 0 1) ,与其它 3组比较也有非常显著的差异 (P <0 0 1)。A组和C组PAdT有显著的增高 (P <0 0 5 )。提示改良明胶和尿联明胶在临床上可能比右旋糖酐 70使用更大的量而不造成出血倾向 ,明胶类液体较晶体液在术中更能稳定血小板 ,在某些方面可能有助于止血功能的稳定。 To investigate the effects of platelet glycoproteins after infusion of four kinds of solutions in vivo (30ml/kg), 105 patients for selective cholecystectomy were randomly divided into four groups.Normal saline was infused in group A patients,dextran 70 for group B, urea linked gelatin for group C, and modified fluid gelatin for group D. Blood samples from patients were taken before the infusion and two hours and three hours after the infusion for the measurement of platelet adhesion(PAdT), vonWillebrand factor (vWF), and glycoproteinⅠb/Ⅰx (GPⅠb/Ⅰx). As compared with other groups the level of vWF and GPⅠb/Ⅰx decreased significantly in group B( P <0 01). 2-3 hours after the infusion,the levels of them were decreased in group B( P <0 01), compared with group A and group C. PAdT increased significantly in group A( P <0 01), and decreased obviously in group B. Infusion of a large dose of dextran decreased GPⅠb/Ⅰx and inhibited platelet function. Gelatin could steady the function of platelet.
出处 《解放军医学杂志》 CAS CSCD 北大核心 2001年第8期591-592,共2页 Medical Journal of Chinese People's Liberation Army
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