烧伤病人血栓前状态的研究  

Study on prethrombotic state in burn patients

作　　者：王鸿利[1] 邵慧珍[1] 支立民[1] 陈怡群[1] 黄霞萍[1] 张永顶[2] 肖玉瑞[3] 杨丽英[3] 孙珍 史济湘[3] 王振义[1] 

机构地区：[1]上海第二医科大学附属瑞金医院上海血液学研究所,200025 [2]上海第二医科大学检验系九二届硕士研究生,200025 [3]上海第二医科大学灼伤科,200025

出　　处：《中华整形烧伤外科杂志》1993年第6期441-446,479,共6页

摘　　要：我们将78例程度不同的烧伤患者分为四组,在烧伤早期(第1～5天)进行有关凝血、抗凝血、纤溶、血小板计数及功能、血液流变学等22项指标的检测,结果提示在烧伤后的第一个24小时里已出现Fg:Ag、vWF:Ag、PAI:A、TXB_2、HCT和全血粘度的增高,AT～Ⅲ、PC:Ag、FPS、6-酮-PGF_(lα)的下降。并观察到Fg:Ag、vWF:Ag、PAI:A、TXB_2、全血粘度在烧伤后第3、5天仍在继续增加,而AT—Ⅲ、PC、FPS和6-酮-PGF_(lα)则相反,呈现继续下降的趋势。78 burned patients (53 males and 25 females) were classified into 4 groups (mild: 14 cases, moderate: 13 cases, severe: 17 cases and extra—severe: 34 cases) in accordance with criteria established by the Chinese Society for Burns. 22 parameters related to platelet, coagulant and anticoagulant factors, fibrinolysis system and hemorrheology were determined in the first 24 hours, and on the third and fifth post burn days. The results were as follows: Fibrinogen antigen, von Willebrand factor antigen, plasminogen activitor inhibitor activity, thromboxane B2 and hematocrit and whole blood viscosity significantly increased, while antithrombin Ⅲ, protein C antigen, free protein S and 6-Ketoprostagladin F_(1α) markedly decreased as compared with normal control in the first 24 hours postburn. In addition, fibrinogen antigen, von Willebrand factor antigen, plasminogen inhibitor activity, thromboxane B2 and whole blood viscosity were persistently elevated, while antithrombin Ⅲ, protein C, free protein S and 6-Keto-prostaglandin F_(1α) declined on the third and fifth postburn days. These changes resulted in a prethrombotic state, which might be an important factor in the pathogenesis of microthrombosis in burn sites, resulting in deepening of burn wound on the third and fifth days in burn patients.

关 键 词：烧伤 血栓前状态 

分 类 号：R644[医药卫生—外科学]