Erythropoietin (EPO) is known as a classical hematopoietic growth factor, which has been used to treat anemia caused by different reasons. In recent years, EPO's non-hematopoietic biological effects have gradually become a focus. Among these effects, EPO's tissue protection is most attractive and EPO has been proved to protect many different tissues and organs. Myocardial protection has always been the important and key topic in the field of cardiovascular diseases. Reports about EPO's myocardial protective effects have been published in the recent two years, which direct the research about myocardial protection with new ideas. In this article, the discoveries and unsolved problems associated with EPO's myocardial protection were reviewed.
Abstract: Objective To investigate the influence of cardiopul monary bypass(CPB) to the cellular immune function of T lymphocyte. Me th ods Among 500 patients operated from March 2006 to September 2006,30 patients with rheumatic heart disease were selected randomly as the CPB group, which would replace mitral valve; 30 patients with congenital patent ductus arte reriosus as the nonCPB group, which would ligate ductus arteriosus without CPB . The blood was sampled before operation, at the end of CPB or operation, and 24 hours after operation. After T lymphocyte was seperated, the quantum o f T lymphocyte, apoptosis of T lymphocyte, ability of T lymphocyte to kill tumou r cell were measured. Results The quantum of T lymphocyte i n CPB group at the end of CPB was decreased than that before operation (50.9% ±6.8% vs. 58.5%± 9.1%,Plt;0.05); apoptosis of T lymphocyte at the end of CPB and 24 hou rs after operation were increased than that before operation (6.5%±2.2% vs. 0. 9%±1.1%, 5.6%±1.8% vs. 0.9%±1.1%;Plt;0.01); ability to kill tumour cell b reakdown in CPB group at the end of CPB and 24 hours after operation was decrea sed than that before operation (30.4%±6.0% vs. 37.3%±8.6%, 29.0%±4.9% vs . 37 .3%±8.6%;Plt;0.05). Ability to kill tumour cell breakdown in CPB group was lower than that in nonCPB group at the end of CPB (30.4%±6.0% vs. 33.6%±5. 3%, Plt;0.05). Conclusion CPB can depress the cellular im mune function,which causes temporary immune depression to the body.
Objective To explore the role of thrombus precursor protein(TPP) in the monitoring of anticoagulation in the patients with atrial fibrillation (Af) after mechanical heart valve replacement, and suggest the reasonable anticoagulant range. Methods Ninety patients were divided into Af group (n=45), sinus rhythm group (SR group, n=45), and control group (20 patients with non-valvular heart diseases), according to whether Af exist after mitral valve replacement. TPP concentrations and International Normalized Ratio(INR) in the anticoagulant patients were analyzed. Results In patients after mechanical mitral valve replacement, plasma TPP concentrations in both SR group and Af group were lower than that in control group (Plt;0.05,0.01), their INR value were higher than that in control group (Plt;0.01), and Af group had higher plasma TPP concentrations than that in SR group((Plt;)0.05). It was found that there existed contradictions between INR and plasma TPP concentrations in Af group. There were 28 patients with plasma TPP concentrations below 6 μg/ml and without spontaneous bleeding complications in the group with Af, who might be at the optimal anticoagulant status. Their 95% confidence of INR value was 1.90-2.30 and their plasma TPP concentration was 4.29±0.75μg/ml. Conclusion Patients with Af after mechanical heart valve replacement might have higher risk of thromboembolism, INR between 1.90 - 2.30 and plasma TPP concentration between 2.84-6.00 μg/ml might be the optimal anticoagulant therapeutic range.