• 中國醫(yī)學(xué)科學(xué)院 中國協(xié)和醫(yī)科大學(xué) 阜外心血管病醫(yī)院 體外循環(huán)科，北京 100037;

血紅蛋白攜氧載體（Hemoglobin-based oxygen carriers, HBOCs）是一類人工血液代用品，主要是將人或牛的血紅蛋白分離、純化和修飾而得到的制品。經(jīng)過修飾后，其半衰期較長，不易產(chǎn)生腎損害，在低溫、低pH值下仍能較好地向組織釋放O2，并且保存時(shí)間長，應(yīng)用時(shí)無需交叉配型。在心臟外科領(lǐng)域，該類制品不僅可以減少術(shù)后輸血，還可用于體外循環(huán)預(yù)充和心肌保護(hù)，顯示出較好的應(yīng)用前景。

引用本文： 常昕,龍村. 血紅蛋白攜氧載體在心臟外科的應(yīng)用. 中國胸心血管外科臨床雜志, 2007, 14(6): 457-. doi: 復(fù)制

1. 　Stanworth SJ, Cockburn HA, Boralessa H, et al. Which groups of patients are transfused A study of red cell usage in London and southeast England. Vox Sang, 2002, 83(4):352-357.
2. 　Spahn DR, Kocian R. Artificial O2 carriers: status in 2005. Curr Pharm Des, 2005, 11(31):4099-4114.
3. 　龍村. 主編. 體外循環(huán)學(xué). 北京: 人民軍醫(yī)出版社, 2004. 576-577.
4. 　Kleinman S, Chan P, Robillard P. Risks associated with transfusion of cellular blood components in Canda. Transfus Med Rev, 2003, 17(2):120-162.
5. 　Caswell JE, Strange MB, Rimmer DM, et al. A novel hemoglobin-based blood substitute protects against myocardial reperfusion injury. Am J Physiol Heart Circ Physiol, 2005,288(4):H1796-1801.
6. 　Schreiber GB, Busch MP, Kleinman SH, et al. The risk of transfusion-transmitted viral infections. The Retrovirus Epidemiology Donor Study. N Engl J Med, 1996, 334(26):1685-1690.
7. 　Anbari KK, Garino JP, Mackenzie CF. Hemoglobin substitutes. Eur Spine J, 2004, 13( Suppl 1):S76-82.
8. 　Stowell CP, Levin J, Speiss BD, et al. Progress in the development of RBC substitutes, Transfusion, 2001, 41(2):287-299.
9. 　Greenburg AG, Kim HW. Hemoglobin-based oxygen carriers. Crit Care, 2004, 8(Suppl 2):S61-64.
10. 　Cohn SM. Blood substitutes in surgery. Surgery,2000,127(6): 599-602.
11. 　Winslow RM. Blood substitutes. Adv Drug Del Rev,2000,40(3):131-142.
12. 　Spahn DR, Pasch T. Physiological properties of blood substitutes. News Physiol Sci,2001,16(1):38-41.
13. 　Kim HW, Shen TJ, Sun DP, et al. A novel low oxygen affinity recombinant hemoglobin (alpha96val→Trp): switching quaternary structure without changing the ligation state. J Mol Biol, 1995, 248(4):867-882.
14. 　Conover CD, Malatesta P, Lejeune L, et al. The effects of hemodilution with polyethylene glycol bovine hemoglobin(PEG-Hb) in a conscious porine model. J Investig Med, 1996, 44 (5):238-246.
15. 　Hughes GS, Antal EJ, Locker PK , et al. Physiology and pharmacokinetics of a novel hemoglobin-based oxygen carrier in humans. Crit Care Med, 1996, 24(5):756-764.
16. 　Winslow RM. alpha-crosslinked hemoglobin: was failure predicted by preclinical testing Vox Sang, 2000, 79(1):1-20.
17. 　Winslow RM. Blood substitutes. Adv Drug Deliv Rev, 2000, 40(3):131-142.
18. 　趙明霞，龍村，賀學(xué)英，等. 兔體外循環(huán)中聚乙二醇牛血紅蛋白偶聯(lián)物對平均動(dòng)脈壓、膠體滲透壓及p50的影響. 中華實(shí)驗(yàn)外科雜志, 2006, 23(9): 1044-1046.
19. 　LaMuraglia GM, O’Hara PJ, Baker WH, et al. The reduction of the allogenic transfusion requirement in aortic surgery with a hemoglobin-based solution. J Vasc Surg, 2000, 31(2):299-308.
20. 　Lamy ML, Daily EK, Brichant JF, et al. Randomized trial of diaspirin cross-linked hemoglobin solution as an alternative to blood transfusion after cardiac surgery. The DCLHb Cardiac Surgery Trial Collaborative Group. Anesthesiology, 2000, 92(3):646-656.
21. 　Levy JH, Goodnough LT, Greilich PE, et al. Polymerized bovine hemoglobin solution as a replacement for allogeneic red blood cell transfusion after cardiac surgery: results of a randomized, double-blind trial. J Thorac Cardiovasc Surg, 2002, 124(1):35-42.
22. 　Hill SE, Gottschalk LI, Grichnik K. Safety and preliminary efficacy of hemoglobin raffimer for patients undergoing coronary artery bypass surgery. J Cardiothorac Vasc Anesth, 2002, 16(6):695-702.
23. 　Young MA, Riddez L, Kjellstrm BT, et al . MalPEG-hemoglobin (MP4) improves hemodynamics, acid-base status, and survival after uncontrolled hemorrhage in anesthetized swine. Crit Care Med , 2005, 33(8): 1794-1804.
24. 　Schechter AN, Gladwin MT. Hemoglobin and the paracrine and endocrine functions of nitric oxide. N Engl J Med, 2003, 348(15):1483-1485.
25. 　Gulati A, Sharma AC, Singh G. Role of endothelin in the cardiovascular effects of diaspirin crosslinked and stroma reduced hemoglobin. Crit Care Med, 1996, 24(1):137-147.
26. 　Cheng DC, Mazer CD, Martineau R, et al. A phase II dose-response study of hemoglobin raffimer (Hemolink) in elective coronary artery bypass surgery. J Thorac Cardiovasc Surg, 2004, 127(1):79-86.
27. 　Helm RE, Klemperer JD, Rosengart TK , et al. Intraoperative autologous blood donation preserves red cell mass but dose not decrease postoperative bleeding. Ann Thorac Surg, 1996, 62(5):1431-1441.
28. 　劉晉萍, 賀學(xué)英 , 龍村, 等. 聚乙二醇-牛血紅蛋白在體外循環(huán)中對機(jī)體血流動(dòng)力學(xué)變化的研究. 中國體外循環(huán)雜志, 2005, 3(3):157-160.
29. 　Mueller XM, Tevaearai HT, Jegger D, et al. Hemoglobin substitute and cardiopulmonary bypass. ASAIO J, 2000, 46(4):403-408.
30. 　Rajesh KG, Sasaguri S, Tian ZZ, et al. Potential role of mitochondrial permeability transition pore following long-time hypothermic heart preservation. Transplant Proc, 2002, 34(7):2645-2646.
31. 　Marinello E, Tabucchi A, Miraldi F, et al. Role of bovine hemoglobin enriched cardioplegia in myocardial preservation. Adv Exp Med Biol, 2000, 486:171-174.
32. 　Carlucci F, Miraldi F, Barretta A , et al. Preservation of myocardial energy status by bovine hemoglobin solutions during ischemia. Biomed Pharmacother, 2002, 56(5):247-253.
33. 　Serna DL, Powell LL, Kahwaji C, et al. Cardiac function after eight hour storage by using polyethylene glycol hemoglobin versus crystalloid perfusion. ASAIO J, 2000, 46(5):547-552.
34. 　Jones BU, Serna DL, Smulowitz P, et al. Extended ex vivo myocardial preservation in the beating state using a novel polyethylene glycolated bovine hemoglobin perfusate based solution. ASAIO J, 2003, 49(4):388-394.
  1. 1. 　Stanworth SJ, Cockburn HA, Boralessa H, et al. Which groups of patients are transfused A study of red cell usage in London and southeast England. Vox Sang, 2002, 83(4):352-357.
  2. 2. 　Spahn DR, Kocian R. Artificial O2 carriers: status in 2005. Curr Pharm Des, 2005, 11(31):4099-4114.
  3. 3. 　龍村. 主編. 體外循環(huán)學(xué). 北京: 人民軍醫(yī)出版社, 2004. 576-577.
  4. 4. 　Kleinman S, Chan P, Robillard P. Risks associated with transfusion of cellular blood components in Canda. Transfus Med Rev, 2003, 17(2):120-162.
  5. 5. 　Caswell JE, Strange MB, Rimmer DM, et al. A novel hemoglobin-based blood substitute protects against myocardial reperfusion injury. Am J Physiol Heart Circ Physiol, 2005,288(4):H1796-1801.
  6. 6. 　Schreiber GB, Busch MP, Kleinman SH, et al. The risk of transfusion-transmitted viral infections. The Retrovirus Epidemiology Donor Study. N Engl J Med, 1996, 334(26):1685-1690.
  7. 7. 　Anbari KK, Garino JP, Mackenzie CF. Hemoglobin substitutes. Eur Spine J, 2004, 13( Suppl 1):S76-82.
  8. 8. 　Stowell CP, Levin J, Speiss BD, et al. Progress in the development of RBC substitutes, Transfusion, 2001, 41(2):287-299.
  9. 9. 　Greenburg AG, Kim HW. Hemoglobin-based oxygen carriers. Crit Care, 2004, 8(Suppl 2):S61-64.
  10. 10. 　Cohn SM. Blood substitutes in surgery. Surgery,2000,127(6): 599-602.
  11. 11. 　Winslow RM. Blood substitutes. Adv Drug Del Rev,2000,40(3):131-142.
  12. 12. 　Spahn DR, Pasch T. Physiological properties of blood substitutes. News Physiol Sci,2001,16(1):38-41.
  13. 13. 　Kim HW, Shen TJ, Sun DP, et al. A novel low oxygen affinity recombinant hemoglobin (alpha96val→Trp): switching quaternary structure without changing the ligation state. J Mol Biol, 1995, 248(4):867-882.
  14. 14. 　Conover CD, Malatesta P, Lejeune L, et al. The effects of hemodilution with polyethylene glycol bovine hemoglobin(PEG-Hb) in a conscious porine model. J Investig Med, 1996, 44 (5):238-246.
  15. 15. 　Hughes GS, Antal EJ, Locker PK , et al. Physiology and pharmacokinetics of a novel hemoglobin-based oxygen carrier in humans. Crit Care Med, 1996, 24(5):756-764.
  16. 16. 　Winslow RM. alpha-crosslinked hemoglobin: was failure predicted by preclinical testing Vox Sang, 2000, 79(1):1-20.
  17. 17. 　Winslow RM. Blood substitutes. Adv Drug Deliv Rev, 2000, 40(3):131-142.
  18. 18. 　趙明霞，龍村，賀學(xué)英，等. 兔體外循環(huán)中聚乙二醇牛血紅蛋白偶聯(lián)物對平均動(dòng)脈壓、膠體滲透壓及p50的影響. 中華實(shí)驗(yàn)外科雜志, 2006, 23(9): 1044-1046.
  19. 19. 　LaMuraglia GM, O’Hara PJ, Baker WH, et al. The reduction of the allogenic transfusion requirement in aortic surgery with a hemoglobin-based solution. J Vasc Surg, 2000, 31(2):299-308.
  20. 20. 　Lamy ML, Daily EK, Brichant JF, et al. Randomized trial of diaspirin cross-linked hemoglobin solution as an alternative to blood transfusion after cardiac surgery. The DCLHb Cardiac Surgery Trial Collaborative Group. Anesthesiology, 2000, 92(3):646-656.
  21. 21. 　Levy JH, Goodnough LT, Greilich PE, et al. Polymerized bovine hemoglobin solution as a replacement for allogeneic red blood cell transfusion after cardiac surgery: results of a randomized, double-blind trial. J Thorac Cardiovasc Surg, 2002, 124(1):35-42.
  22. 22. 　Hill SE, Gottschalk LI, Grichnik K. Safety and preliminary efficacy of hemoglobin raffimer for patients undergoing coronary artery bypass surgery. J Cardiothorac Vasc Anesth, 2002, 16(6):695-702.
  23. 23. 　Young MA, Riddez L, Kjellstrm BT, et al . MalPEG-hemoglobin (MP4) improves hemodynamics, acid-base status, and survival after uncontrolled hemorrhage in anesthetized swine. Crit Care Med , 2005, 33(8): 1794-1804.
  24. 24. 　Schechter AN, Gladwin MT. Hemoglobin and the paracrine and endocrine functions of nitric oxide. N Engl J Med, 2003, 348(15):1483-1485.
  25. 25. 　Gulati A, Sharma AC, Singh G. Role of endothelin in the cardiovascular effects of diaspirin crosslinked and stroma reduced hemoglobin. Crit Care Med, 1996, 24(1):137-147.
  26. 26. 　Cheng DC, Mazer CD, Martineau R, et al. A phase II dose-response study of hemoglobin raffimer (Hemolink) in elective coronary artery bypass surgery. J Thorac Cardiovasc Surg, 2004, 127(1):79-86.
  27. 27. 　Helm RE, Klemperer JD, Rosengart TK , et al. Intraoperative autologous blood donation preserves red cell mass but dose not decrease postoperative bleeding. Ann Thorac Surg, 1996, 62(5):1431-1441.
  28. 28. 　劉晉萍, 賀學(xué)英 , 龍村, 等. 聚乙二醇-牛血紅蛋白在體外循環(huán)中對機(jī)體血流動(dòng)力學(xué)變化的研究. 中國體外循環(huán)雜志, 2005, 3(3):157-160.
  29. 29. 　Mueller XM, Tevaearai HT, Jegger D, et al. Hemoglobin substitute and cardiopulmonary bypass. ASAIO J, 2000, 46(4):403-408.
  30. 30. 　Rajesh KG, Sasaguri S, Tian ZZ, et al. Potential role of mitochondrial permeability transition pore following long-time hypothermic heart preservation. Transplant Proc, 2002, 34(7):2645-2646.
  31. 31. 　Marinello E, Tabucchi A, Miraldi F, et al. Role of bovine hemoglobin enriched cardioplegia in myocardial preservation. Adv Exp Med Biol, 2000, 486:171-174.
  32. 32. 　Carlucci F, Miraldi F, Barretta A , et al. Preservation of myocardial energy status by bovine hemoglobin solutions during ischemia. Biomed Pharmacother, 2002, 56(5):247-253.
  33. 33. 　Serna DL, Powell LL, Kahwaji C, et al. Cardiac function after eight hour storage by using polyethylene glycol hemoglobin versus crystalloid perfusion. ASAIO J, 2000, 46(5):547-552.
  34. 34. 　Jones BU, Serna DL, Smulowitz P, et al. Extended ex vivo myocardial preservation in the beating state using a novel polyethylene glycolated bovine hemoglobin perfusate based solution. ASAIO J, 2003, 49(4):388-394.