CAJ | 학술논문

目的探讨不同剂量乌司他丁对常温体外循环(CPB)兔血小板数量和功能的影响.方法健康大耳白兔50只,月龄5～6月,体重2.3～3.0 kg,随机分为5组(n=10),不同剂量乌司他丁组(U_(1～4)组)于CPB前即刻分别静脉注射乌司他丁1×10~4、3×10~4、5×10~4、10×10~4 U/kg,对照组(C组)给予等容量生理盐水.于CPB前即刻(T_0)、CPB结束即刻(T_1)、结束后1 h(T_2)、2 h(T_3)、3 h(T_4)时记录MAP、HR和红细胞压积(Hct),同时取血样,行血小板计数,测定血小板粘附率(PAR)和血小板膜糖蛋白Ⅰ b(Gp Ⅰ b)、GpⅡb和GpⅢa受体分子数.结果与C组比较,U_2组、U_3组和U_4组Gp Ⅰ b、GpⅡ b、GpⅢa受体分子数升高,U_4组PAR升高(P<0.05).与U_1组比较,U_3组Gp Ⅰ b受体分子数升高,U_4组Gp Ⅰ b、GpⅡb受体分子数升高(P<0.05).与U_2组比较,U组Gp Ⅰ b、Gp Ⅱ b受体分子数升高(P<0.05).各组间血小板计数比较差异无统计学意义(P>0.05).结论 CPB前应用乌司他丁3×10~4～5×10~4 U/kg可呈剂量依赖性地抑制兔血小板膜糖蛋白受体分解,剂量达10×10~4 U/kg时可提高血小板的粘附功能.
목적 탐토불동제량오사타정대상온체외순배(CPB)토혈소판수량화공능적영향.방법 건강대이백토50지,월령5～6월,체중2.3～3.0 kg,수궤분위5조(n=10),불동제량오사타정조(U_(1～4)조)우CPB전즉각분별정맥주사오사타정1×10~4、3×10~4、5×10~4、10×10~4 U/kg,대조조(C조)급여등용량생리염수.우CPB전즉각(T_0)、CPB결속즉각(T_1)、결속후1 h(T_2)、2 h(T_3)、3 h(T_4)시기록MAP、HR화홍세포압적(Hct),동시취혈양,행혈소판계수,측정혈소판점부솔(PAR)화혈소판막당단백Ⅰ b(Gp Ⅰ b)、GpⅡb화GpⅢa수체분자수.결과 여C조비교,U_2조、U_3조화U_4조Gp Ⅰ b、GpⅡ b、GpⅢa수체분자수승고,U_4조PAR승고(P<0.05).여U_1조비교,U_3조Gp Ⅰ b수체분자수승고,U_4조Gp Ⅰ b、GpⅡb수체분자수승고(P<0.05).여U_2조비교,U조Gp Ⅰ b、Gp Ⅱ b수체분자수승고(P<0.05).각조간혈소판계수비교차이무통계학의의(P>0.05).결론 CPB전응용오사타정3×10~4～5×10~4 U/kg가정제량의뢰성지억제토혈소판막당단백수체분해,제량체10×10~4 U/kg시가제고혈소판적점부공능.
Objective To investigate the effects of different doses of ulinastatin on platelet counts and function after normothermic cardiopulmonary bypass (CPB) in rabbits. Methods Fifty lung-ear white rabbits aged 5-6 months weighing 2.3-3.0 kg were randomly assigned to one of 5 groups (n = 10 each) : control group (group C) and4 ulinastatin groups (group U~1, U_2,U_3,U_4). The rabbits received ulinastatin 1×10~4, 3×10~4, 5×10~4 and 10×10~4 U/kg before CPB in group U~1, U_2, U_3 and U_4 respectively while equal volume of normal saline was given instead of ulinastatin in group C. All rabbits underwent CPB for 30 min at perfusion flow of 72-120 ml·kg~(-1) ·min~(-1). The rectal temperature was maintained at 36.5-37.5℃. Hemodynamic parameters were recorded and blood platelet count, platelet adhesion rate and platelet membrane glycopretein Gp Ⅰ b, Gp Ⅱ b, Gp Ⅲ a receptors were determined before CPB (baseline), at termination of CPB and at 1, 2 and 3 h after CPB. Results The platelet counts were significantly decreased after CPB in all 5 groups (P< 0.05), but there was no significant difference among the 5 groups. The platelet adhesion rates were significantly decreased after CPB as compared with the baseline value before CPB in all 5 groups but the platelet adhesion rates were significantly higher after CPB in group U_4 than in group C. The number of molecules of Gp Ⅰ b, Gp Ⅱ b and Gp Ⅲ a receptors was significantly decreased after CPB in all 5 groups. The number of molecules of Gp Ⅰ b, Gp Ⅱ b and Gp Ⅲ a receptors after CPB was significantly higher in group U_2, U_3 and U_4 than in group C, and there was no significant difference between group U_3 and U_4 . Conclusion Ulinastatin 3×10~4-5×10~4 U/kg administered before CPB can inhibit breakdown of platelet membrane glycoprotein receptors. Ulinastatin 10×10~4 U/kg can preserve the platelet adhesion function.