血小板计数与肝素耐药的相关性研究

研究心脏手术中的血小板（PLT）计数与肝素耐药的相关性。随机将120例行心脏手术患者根据PLT计数分成仍血小板组（PLT〈150×10^9·L^-1）和高血小板组（PLT〉250×10^9·L^-1），每组各60例。麻醉后抽取中心静脉血监测浏活凝血时间（ACT）基础值，肝素化后ACT值，肝素总用量和鱼精蛋白用量，并计算鱼精蛋白／肝素用量。首次肝素化石静脉血ACT值两组间差异无统计学意义。但两组ACT基础值差异有统计学意义（P〈0．05）。高血小板组肝素抗凝并足者有26例（43．3％），低血小板组仅4例（6．67％），两组间差异有统计学意义（P〈0．01）。肝素及鱼精蛋白用量均有朔计学意义，前者用量较大（P〈O．01）而后者用量较少（P〈O．05）。心脏手术时血小板计数高者易出现肝素抗凝不足。肝素需要量较大而鱼精蛋白用量较少。高血小板组以先心病患儿为多。

A Study of Correlation between Platelet Counts and Heparin Anticoagulant Deficiency

To investigate the correlation between platelet counts and heparin anticoagulant deficiency in open heart surgery. 120 cardiac surgical patients were randomly divided into group A （platelet counts 〈150× 10^9 · L^-1,n=60） and group B （platelet counts〉250 X 10^9 · L^-1,n= 60 ）. Blood samples from CVP catheter were taken to measure activated clotting time （ACT） at the following points： before heparinization and 5 minutes after heparinization. The requirements of heparin and protamine were recorded and protamine/heparin ratios were calculated. The baseline of ACT in group B was lower than in group A （P〈0.05）. In Group B, twenty-six patients showed relative heparin anticoagulant deficiency （43.3 G ）, and four patients in group A （6.67G）（P〈0.01）. The dosage of protamine in group B was less than that in group A . There was a statistically significant increase of heparin anticoagulant deficiency in patients with platetlet counts than 250 ×10^9 L^-1 during open heart surgery . In patients with higher platelet counts, the requirements of heparin were larger but than of protamine were smaller. Most of them were pediatric congenital heart disease.