前列地尔对严重烧伤患者血栓前状态的影响  

Effects of liposome prostaglandin E1 on prethrombotic state of patients with severe burn

作　　者：马玉[1] 袁克俭[1] 杨惠忠[1] 乔亮[1] 王学锋[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院灼伤整形科,上海200025 [2]上海交通大学医学院附属瑞金医院临床输血科,上海200025

出　　处：《上海交通大学学报（医学版）》2011年第7期975-979,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市教委基金(06BZ037)~~

摘　　要：目的观察严重烧伤早期应用前列地尔(Lipo-PGE1)对患者血栓前状态的影响。方法 25例烧伤总面积≥50%总体表面积(TBSA)和(或)Ⅲ度烧伤面积≥20%TBSA的严重烧伤患者经随机双盲法入选Lipo-PGE1组(n=15)和对照组(n=10),两组患者入院后均给予常规治疗,Lipo-PGE1组加用Lipo-PGE110μg静脉推注(1次/d,连用7 d)。分别于烧伤后1、2、3、7、14 d采集血样,测定抗凝血酶抗原(AT:Ag)、抗凝血酶活性(AT:A)、蛋白C活性(PC:A)、蛋白S活性(PS:A)、血小板表面P选择素(P-sel)、可溶性纤维蛋白单体复合物(SFMC)、纤溶酶-抗纤溶酶复合物(PAP)。运用凝血分析仪描记血栓弹力图(TEG),对Lipo-PGE1组患者用药前后的TEG各项参数进行分析,评估凝血功能。结果两组患者烧伤后不同时间点的AT:Ag、AT:A、PC:A、PS:A、SFMC和PAP比较差异无统计学意义(P>0.05);烧伤后3、7 d,Lipo-PGE1组血小板表面P-sel表达显著低于对照组(P<0.05)。TEG参数分析结果显示:Lipo-PGE1组用药前后的凝血活酶生成时间分别为(3.77±0.90)min和(4.98±0.72)min,用药后较用药前明显延迟(P<0.05)。结论严重烧伤早期应用Lipo-PGE可以有效改善患者的血栓前状态。Objective To observe the effects of liposome prostaglandin E1(Lipo-PGE1) on prethrombotic state of patients with severe burn. Methods Twenty-five patients with severe burn whose total burn area≥ 50% total body surface area(TBSA) and/or burn area of degree Ⅲ≥ 20% TBSA were randomly divided into Lipo-PGE1 group(n=15) and control group(n=10).Patients in both groups were given conventional treatment after admission,and those in Lipo-PGE1 group were managed with intravenous injection of Lipo-PGE1(10 μg once a day for 7 d).Blood samples were collected 1 d,2 d,3 d,7 d and 14 d after burn,and antithrombin antigen(AT:Ag),antithrombin activity(AT:A),protein C activity(PC:A),protein S activity(PS:A),P-selectin(P-sel),soluble fibrin monomer complex(SFMC) and plasmin-α2-antiplasmin complex(PAP) were determined.Thromboelastogram(TEG) was recorded with coagulation analyzer,and the parameters of TEG in Lipo-PGE1 group were compared before and after treatment to assess the coagulation function.Results There was no significant difference in AT:Ag,AT:A,PC:A,PS:A,SFMC and PAP between tow groups at different time points after burn(P>0.05).The expression of P-sel in Lipo-PGE1 group was significantly lower than that in control group 3 d and 7 d after burn(P<0.05).Analysis of TEG parameters revealed that the thromboplastin generation time was(3.77±0.90) min before treatment and(4.98±0.72) min after treatment in Lipo-PGE1 group,and the latter was significantly longer than the former(P<0.05). Conclusion Early application of Lipo-PGE1 after severe burn may effectively improve the prethrombotic state.

关 键 词：前列地尔 严重烧伤 血栓前状态 

分 类 号：R644[医药卫生—外科学]