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題名 | The Diagnostic Value of Glycosybated Hemoglobin in Intravascular Hemolysis after Cardiac Surgery=醣化血色素對心瓣膜置換手術後所引起之微血管病變性溶血症之診斷價值 |
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作者 | 何照洪; |
期刊 | 醫學研究 |
出版日期 | 19900900 |
卷期 | 11:2 1990.09[民79.09] |
頁次 | 頁23-32 |
分類號 | 416.262 |
語文 | eng |
關鍵詞 | 心瓣膜; 置換手術; 血色素; 病變性; 微血管; 溶血症; 醣化; |
中文摘要 | 在42個準備作心臟外科手術之病人中,分別在手術前,手術後1-天及手術後11-42天測定醣化血色素,血色素,紅血球容積,LDH及血清膽色素值。病人平均年齡為39.90歲,最小為4歲,最大為68歲。手術後早期,血色素及紅血球容積均減少,但醣化血色素之平均值並不減少。因此在手術後之早期中,急性失血比溶血現象較明顯,而血色素之下降表示急性失血之程度。在手術後期,醣化血色素減少而血色素及紅血球容積卻不減少。這表示在這時期中,慢性溶血存在,但骨髓已產生代償,因此血色素並不下降。而醣化血色素之下降,證明其為慢性溶血症之一個具特異性及敏感性之指標。本實驗中,我們發現心臟手術後產生慢性輕度溶血症之頻率頗高(64.71%),這種溶血症之發現,需較敏感之方法。而醣化血色素之測定逼一種簡單、容易及敏感之方法,以測定慢性溶血症之存在;因此對於懷疑有溶血性發生的病人,皆應測定醣化血色素。 |
英文摘要 | Glycosylated hemoglobin (GH), hemoglobin (Hb), hematocrit, LDH and serum bilirubin were measured pre*operatively, 1-10 days as well as 11-42 days post-operatively in 42 patients with cardiac vascular or valve diseases undergoing cardiac surgery. Their mean age was 39.90 yr, ranging from 4 to 68 yr. In the early days after operation, Hb and hematocrit, but not the GH percentage, were significantly decreased. This demonstrates that in this stage, acute blood loss rather than hemolysis is more prominent, and the fall of hemoglobin means acute blood loss, In the later days afteopertion, GH, but not Hb or hematocrit, decreased significantly, this indicates the presence of chronic hemoloysis with bone marrow compensation, and the fall of GH represents a sensitive and specific indicator of chronic hemolysis. In our study, the incidence of chronic mild hemolysis was very high (64.71%) in the later days after cardiac surgery, We conclude that GH determination is a simple, easy and sensitive method and suggest to detect it in every case with suspicion of hemolysis. |
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