添加紫外线照射充氧血预充液对体外循环手术红细胞膜ATP酶的保护作用

目的 探讨体外循环心内直视手术中使用添加紫外线照射充氧血（UBIO）预充液对患者红细胞膜ATP酶的作用.方法 体外循环心脏瓣膜置换手术患者44例,随机分为治疗组和对照组（每组各22例）.治疗组于全身血液肝素化后通过锁骨下静脉按10 ml/kg体重放血或使用库血行紫外线照射并充氧后加入预充液,对照组使用等量生理盐水,其他处理两组相同.两组均在麻醉诱导后（T1）,转机30 min（T2）,开放主动脉30 min（T3）、2 h（T4）及术后第1天（T5）抽取动脉血测定Na＋-K＋-ATPase、Ca2＋-Mg2＋-ATPase活性.结果 体外循环开始后,两组T2～T4时点红细胞膜Na＋-K＋-ATPase、Ca2＋-Mg2＋-ATPase活性水平均明显下降（P〈0.05）;对照组T2～T4时点活性水平较治疗组下降更明显（P〈0.05）.结论 UBIO通过减轻体外循环手术患者红细胞脂质过氧化作用,对体外循环手术红细胞膜ATP酶有一定的保护作用.

The protective effect of ultraviolet blood irradiation and oxygenation(UBIO ) on ATPase activity of erythrocyte membrance in patients undergoing cardiopulmonary bypass

Objective To evaluate the protective effect of ultraviolet blood irradiation and oxygenation（U- BIO） on activities of Na^＋-K^＋-ATPase and Ca^2＋-Mg^2＋-ATPase of erythrocyte membrance in patients undergoin cardiopulmonary bypass （CPB）. Methods Forty-four patients undergoing elective heart valve replacements with CPB were randomly divided into control group （n=22） and test group （n=22）. In test group, UBIO accumulated from the subclavian vein （10 ml/kg） or blood bank was dealt with the ultraviolet irradiation （wave length 240-300 nm） and oxygenation（FiO2 100%）, and the UBIO was added into cardiopulmonary-bypass circuit priming before CPB while in the control group equivalent quantitative saline was added. Blood samples were collected from radial arterial after induction of anaesthesia, 30 rain after initiation of CPB, 30 min and 2 h after aorta declamping, and 24 h after surgery for dynamically detecting the alteration of activities of Na^＋-K^＋-ATPase and Ca^2＋-Mg^2＋-ATPase of erythrocyte membranee. Results The levels of Na^＋-K^＋-ATPase and Ca^2＋-Mg^2＋-ATPase decreased significantly after initiation of CPB, 30 rain after initiation of CPB, 30 min and 2 h after aorta declamping. The levels of Na^＋-K^＋-ATPase and Ca^2＋-Mg^2＋-ATPase were significantly lower in the control group than those in the test group （P〈0.05）. Conclusion UBIO can markedly mitigate the decreased levels of ATPase activities of erythroeyte membrance in patients undergoing open heart surgery with CPB. This protective effect may be due to the attenuated injury of erythrocyte lipid peroxidation caused by CPB.