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The Hematological Deterioration and its Influences to the Human Body During Cardiopulmonary Bypass

体外循环过程中血液学恶化及其对人体的影响

基本信息

批准号：
01480340
负责人：
EGUCHI Shoji
金额：
$ 4.35万
依托单位：
Niigata University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1989
资助国家：
日本
起止时间：
1989 至 1990
项目状态：
已结题

项目摘要

The study is composed of the injury and reactions by each blood components such as leukocyte, platelet, coagulant factors, complement and other serum active proteins during cardiopulmonary bypass.Following data was obtained form clinical cardiopulmonary bypass in our hospital and experimental mock circulation with artificial lung.1. Accession of coagulation cascade and consumption of each coagulant factors were observed and finally thrombin-antithrombin III complex increased in circulating blood after clinical cardiopulmonary bypass. Activation of kininogen and prekalikrein followed by decreasing fibrinogen in mock circuits with normal temperature.2. Fibrinolytic process with increased plasmin-d_2plasmin inhibitor complex was always observed in clinical cardiopulmonary bypass circulation, otherwise, mild fibrinolysis occurred in mock circulation.3. The platelet counts decreased immediately after cardiopulmonary bypass in both clinical and experimental circulation and subsequent increasing possibly due to mobilization from pooled platelets in clinical circulation.platelet aggregation activity was strongly suppressed in both circulation and need several days to get normal activity in clinical cases.4. Polymorphonuclear leukocyte counts initially decreased during the hypothermic anoxic arrest and markedly increased after rewarming. Serum levels of neutrophil elastase significantly rose during CPB and superoxide anion was more generated after CPB.5. Both complement factor 4 and 3 were activated during CPB under following circumstances ex. hypothermia or normothermia, in clinical or mock circuits.Some drugs would be applied to diminish the hematological change and influence to the human body.

本研究包括体外循环期间血液中白细胞、血小板、凝血因子、补体等血液成分的损伤和反应。以下数据来自本院临床体外循环和人工肺模拟循环实验。观察凝血级联的增加和各凝血因子的消耗，最终使体外循环后循环血中凝血酶-抗凝血酶III复合体增加。结论：1.在常温模拟回路中，激肽原和前激肽释放酶激活，纤维蛋白原降低。临床体外循环中可见纤溶酶-D_2纤溶酶抑制物复合体增多的纤溶过程，而模拟循环可见轻度纤溶作用。临床和实验循环中的血小板计数在体外循环后即刻下降，随后可能由于临床循环中聚集的血小板的动员而升高，两种循环中的血小板聚集活性都受到强烈的抑制，临床病例需要数天时间才能恢复正常活动。中性粒细胞计数在低温缺氧停搏时最初下降，复温后显著升高。CPB期间血清中性粒细胞弹性蛋白酶水平明显升高，CPB后超氧阴离子生成增多。在CPB期间，补体4和补体3在以下情况下均被激活。低温或常温，在临床或模拟电路中。一些药物可用于减轻血液系统的变化和对人体的影响。