Contrast The Change Of Platelet And P-Selectin Expression Between Open-Heart Surgery With Beating-Heart And Open-Heart Surgery With Arrested Heart

Objective:Through determine the level of P-selectin expression and platelets count in preoperative,intraoperative and postoperative.Contrast the change of platelets and p-selectin expression between open-heart surgery with beating-heart and open-heart surgery with arrested heart,to explore the better way of open-heart surgery with good effect of body-protecting.It also help us to evaluate the change of blood clotting and inflammatory reaction after open-heart surgery,to prevent and cure the bleeding risk and inflammation lead by open-heart surgery.Method:40 patients scheduled for elective cardiac valvular re-placement were randomly divided into the experimental group an the control group.There were 20 patients in each group.Let the experimental group accept open-heart surgery with beating-heart and the control group accept open-heart surgery with arrested heart.Each group has no difference between each other before operating.Them draw their blood from vein at preoperative(T1),CPB20min(T2),CPB40min(T3),after the CPB(T4),after the operation(T5),12h after the operation(T6),24h after the operation(T7).Store the sample of P-selectin in frige under -20℃,them determined it by enzyme linked immunosorbent assay.And the platelets count was determined by autoanalyser, The density was corrected by HCT of preoperative.Spss 13.0 statistical software was applied for data analysis,P-value less than 0.05 were considered significant. The Repeated Measures ANOVA and Multielement ANOVA were used to compare the different of two groups.,and the Pearson Correlation was used to compare the relationship of two groups.Results:1,The change of platelets count:there are statistical difference between two group's platelets count during the open-heart operation (F=122.961,P＜0.01),and the reciprocation relationship exits between each testing point and group-separation factors(F=5.181,P＜0.01).With time-lapsing, the tendency changing of platelets count between two groups have statistical difference(F=11.551,P＜0.01)2,The change of P-selectin expressinon:there are statistical difference between each group's P-selectin expressions during the open-heart operation (F=392.61,P＜0.01),and the reciprocation relationship exits between each testing point and group-separation factors(F=11.475,P＜0.01).With time-lapsing, the tendency changing of P-selectin expression between two groups have statistical difference(F=79.632,P＜0.01)3,Pearson correlation:the change of platelets count is obviously inverse correlated with the change of P-selectin expression undergoing open-heart surgery,pearson correlation is 0.963(P＜0.01).Conclusion:during the open-heart surgery,platelets get activation and the count is decreased,although it begin revert after operation,it still can't revert to the normal level even till to the 24h after operation.P-selectin expression got more and more enhancement after the open-heart surgery began,start descending after the operation,but still remains at a higher level than normal until to the 24 hours after open-heart operation,and the P-selectin expression of open-heart operation with beating-heart is lower than the P-selectin expression of open-heart operation with arrested heart during the operation.Besides,the change of platelets count inverse correlating with the change of P-selectin expression undergoing open-heart operation.It means maybe P-selectin shedding from platelets is the main reason.