RETRACTED: Does the preparation of heparin influence anticoagulation during cardiopulmonary bypass?
RETRACTED: Does the preparation of heparin influence anticoagulation during cardiopulmonary bypass?
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DOI：
10.1016/1053-0770(91)90118-d
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发表时间：
1991-10-01
影响因子：
2.8
通讯作者：
Hempelmann, G
中科院分区：
文献类型：
--
作者：
Boldt, J;Zickmann, B;Hempelmann, G
市面上有不同厂家生产的各种肝素制剂。研究了四组10例择期冠状动脉旁路移植术患者单次或重复给药（60分钟后）后，牛肺肝素（BLH）和猪粘膜肝素（PMH）对抗凝血和肝素血药浓度的影响。注射肝素后肝素血药浓度显著升高（BLH最小，1.67 U/mL；最大值，2.10 U/mL； PMH最小，1.69 U/mL；最大值，2.15 U/mL）。初始剂量60分钟后，接受PMH治疗的患者肝素血浆水平较高。负荷剂量后60分钟补充肝素剂量仅与猪粘膜肝素一起增加血浆肝素浓度。尿中肝素的消除在各组之间没有差异。纤维蛋白原和抗凝血酶III浓度以及活化凝血时间（ACT，均大于400秒）和部分凝血活素时间（PTT，均大于300秒）在两组间均无差异，提示两种肝素在旁路期间抗凝有效。由此可见，两种肝素均能达到充分的抗凝作用。PMH似乎作用时间更长，只有当体外循环持续时间超过90分钟时，这些患者才有必要重复给药。
Various preparations of heparin from different manufacturers are commercially available. The influence of bovine lung heparin (BLH) and porcine mucosal heparin (PMH) on anticoagulation and heparin plasma concentration was investigated in four groups of 10 patients undergoing elective aortocoronary bypass grafting either after single dose or repetitive dose (after 60 minutes) of one of these heparin preparations. Heparin plasma concentration increased significantly after injection of heparin (BLH: minimum, 1.67 U/mL; maximum, 2.10 U/mL; PMH: minimum, 1.69 U/mL; maximum, 2.15 U/mL). Sixty minutes after the initial dose, heparin plasma levels were higher in the patients who received PMH. Supplemental heparin doses 60 minutes after the loading dose increased plasma heparin concentration only with porcine mucosal heparin. Elimination of heparin in the urine was not different among the groups. Fibrinogen and antithrombin III concentrations, as well as activated clotting time (ACT; always greater than 400 seconds) and partial thromboplastin time (PTT; always greater than 300 seconds), did not differ among the groups, indicating effective anticoagulation during the bypass period with both types of heparin. It can be concluded that sufficient anticoagulation can be achieved with either kind of heparin. PMH seems to be longer acting and a repeat dose in these patients seems to be necessary only if cardiopulmonary bypass lasts longer than 90 minutes.