【摘要】 目的　研究体外循环下心脏手术病人的血小板 (Plt)、抗凝血酶Ⅲ (AT Ⅲ )活性与肝素相对耐药的相关性。方法　根据术前Plt水平将 6 0例心脏手术病人分成两组 ,A组为高Plt组 (Plt>2 5 0× 10 9/L) ,B组为低Plt组 (Plt <15 0× 10 9/L ) ,每组 30例。麻醉诱导后抽取中心静脉血测定AT Ⅲ活性、全血活化凝固时间 (ACT)基础值及肝素化后ACT值。结果　A组AT Ⅲ活性显著低于B组 (P <0 .0 5 ) ,肝素相对耐药患者多于B组 ,尤其以AT Ⅲ活性 <70 %的患者肝素相对耐药发生率明显增多。结论　Plt计数偏高与AT Ⅲ活性低有一定相关性 ,Plt计数高者AT Ⅲ活性下降明显 ,出现肝素相对耐药的可能性较大更多还原

【Abstract】 Objective To observe the relationship of platelet (Plt),the activity of antithrombin Ⅲ(AT-Ⅲ) and the heparin tolerance in patients during cardiac surgery.Methods 60 patients undergoing selective cardiac surgery were involved in the research.They were divided into two groups according to their preoperative Plt:group A (n=30) with Plt>250×10 9/L,group B (n=30) with Plt<150×10 9/L.The activity of AT-Ⅲ was measured immediately after center venous catheterization before heparnization and the active coagulation time (ACT) was monitored at both before and after loading heparin injection.Results The activity of AT-Ⅲ in group A was significantly lower than that in group B.Heparin tolerance happened more frequently in patients with a lower Plt,espicially in patients with activity of AT-Ⅲ below 70%.Conclusion A higher Plt is correlated with the decrease of the activity of AT-Ⅲ.The patients with a higher Plt and a decreased activity of AT-Ⅲ may have more risk of suffering from heparin tolerance during cardiac surgery.更多还原