紫绀型先天性心脏病体外循环对血小板膜受体的影响

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目的 观察紫绀型先天性心脏病患儿心肺转流(CPB) 期间血小板的灭活机制。方法 用流式细胞术测定33 例紫绀型先天性心脏病患儿在CPB下行心内矫正术时的血小板膜受体CD62p和CD63 的变化,同时与35 例非紫绀型先天性心脏病患儿CPB下行心内矫正术时的相同指标进行比较。结果 紫绀组与非紫绀组血小板计数分别由术前的(144 .55 ±39.76) ×106/L、(272 .46 ±59 .96)×106/L降到术后的(132.65 ±89 .25) ×106/L,(180.37 ±44 .93) ×106/L。但紫绀组血小板膜受体CD62p 和CD63 较非紫绀组增加明显,且两组主要指标比较有明显差异(P< 0.05) 。结论 CPB期间紫绀组的血小板膜受体CD62p 和CD63 大量被激活,但因血小板总数下降,出血倾向仍然明显 Objective To observe the mechanism of platelet inactivation during cardiopulmonary bypass (CPB) in children with cyanotic congenital heart disease. Methods Flow cytometry was used to determine the changes of platelet membrane receptors CD62p and CD63 in 33 children with cyanotic congenital heart disease undergoing cardiopulmonary bypass under CPB. Meanwhile, 35 children with cyanotic congenital heart disease The same indicators during downcoronary correction were compared. Results The platelet count of cyanotic group and non-cyanotic group decreased from (144.55 ± 39.76) × 106 / L to (272.46 ± 59.96) × 106 / L to (132.65 ± 89.25) × 106 / L, (180.37 ± 44.93) × 106 / L. However, CD62p and CD63 of platelet membrane receptors in cyanotic group increased significantly compared with non-cyanotic group, and there were significant differences between the two groups (P <0.05). Conclusions Cytoplasmic membrane receptor CD62p and CD63 are activated in large numbers in cyanotic group during CPB, but the tendency of bleeding is still obvious due to the decrease of the total number of platelets
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