背景:磷酸胆碱已成为体外循环(CPB)回路中的潜在辅助药物。磷酸胆碱作为CPB电路的涂层,可能增强生物相容性和减少血栓形成事件。然而,其对特定患者人群和手术结局的影响仍未得到充分研究.
方法:在这项回顾性研究中,我们分析了60例CPB心脏手术患者的数据,冠状动脉旁路移植术(CABG)各20例,二尖瓣修复术,主动脉瓣置换术.患者队列分为两组-30例CPB回路涂有磷酸胆碱(磷酸胆碱涂层组)的患者和30例未接受磷酸胆碱补充剂或回路涂层的患者。两组均采用相同的CPB电路设计进行手术。我们评估了没有不良事件,安全,和功效参数,包括失血,凝血,以及CPB电路的结构完整性。此外,我们测量了平均白蛋白水平(g/dL)的变化,平均血小板计数(×109/L),和CPB前后的抗凝血酶III(ATIII)水平。
结果:回顾性分析显示两组均无不良事件发生。在磷酸胆碱涂层组中,与非磷酸胆碱涂层组相比,平均白蛋白水平的δ变化有显着差异(0.87±0.1vs.1.65±0.2g/dL,p值0.021),平均血小板计数(42.251±0.121vs.54.21±0.194×109/L,p值0.049),和ATIII水平(16.85±0.2vs.31.21±0.3p值0.017)。CPB后围手术期人类复杂单位的消耗量显着减少(3vs.12,p值0.019)。
结论:两组,磷酸胆碱和非磷酸胆碱,证明没有不良事件,并且该系统对医源性并发症是安全的。我们的研究结果表明,在CPB电路上使用磷酸胆碱涂层,在没有补充磷酰胆碱的情况下,在心脏手术中与平均白蛋白水平的有利变化有关,平均血小板计数,和ATIII水平。需要进一步的研究来阐明磷酸胆碱对患者预后和CPB回路性能的影响程度。
BACKGROUND: Phosphorylcholine has emerged as a potential adjunctive agent in cardiopulmonary bypass (CPB) circuits. Phosphorylcholine serves as a
coating for the CPB circuit, potentially enhancing biocompatibility and reducing thrombotic events. However, its impact on specific patient populations and procedural outcomes remains underexplored.
METHODS: In this retrospective study, we analyzed data from 60 patients who underwent cardiac surgery with CPB, comprising 20 cases each of coronary artery bypass grafting (CABG), mitral valve repair, and aortic valve replacement. The patient cohort was divided into two groups-30 patients whose CPB circuits were coated with phosphorylcholine (phosphorylcholine-coated group) and 30 patients who did not receive phosphorylcholine supplementation or circuit
coating. Both groups underwent surgery with identical CPB circuit designs. We assessed the absence of adverse events, safety, and efficacy parameters, including blood loss, clotting, and the structural integrity of the CPB circuit. Additionally, we measured changes in mean albumin levels (g/dL), mean platelet counts (×109/L), and antithrombin III (ATIII) levels before and after CPB.
RESULTS: The retrospective analysis revealed an absence of adverse events in both groups. In the phosphorylcholine-coated group compared to the non-phosphorylcholine-coated group, there was a notable difference in the delta change in mean albumin levels (0.87 ± 0.1 vs. 1.65 ± 0.2 g/dL, p-value 0.021), mean platelet counts (42.251 ± 0.121 vs. 54.21 ± 0.194 × 109/L, p-value 0.049), and ATIII levels (16.85 ± 0.2 vs. 31.21 ± 0.3 p-value 0.017). There was a notable reduction in the perioperative consumption of human complex units after CPB (3 vs. 12, p-value 0.019).
CONCLUSIONS: Both groups, phosphorylcholine and non-phosphorylcholine, demonstrated the absence of adverse events and that the systems are safe for iatrogenic complication. Our findings suggest that the use of phosphorylcholine
coating on the CPB circuit, in the absence of supplementary phosphorylcholine, in cardiac surgery is associated with favorable changes in mean albumin levels, mean platelet counts, and ATIII levels. Further research is warranted to elucidate the full extent of phosphorylcholine\'s impact on patient outcomes and CPB circuit performance.