左旋咪唑对骨折创伤后红细胞生物学行为的影响  

Effect of levamisole on biological behavior of red blood cells after fracture

作　　者：王友华[1] 应朗[1] 刘璠[1] 陆跃[1] 喻德富[1] 

机构地区：[1]南通大学附属医院骨科,江苏省南通市226001

出　　处：《中华创伤骨科杂志》2009年第11期1067-1071,共5页Chinese Journal of Orthopaedic Trauma

基　　金：江苏省卫生厅科研基金资助（H200522）;江苏省“科教兴卫工程”重点医学人才基金资助（RC2007087）

摘　　要：目的通过探讨左旋咪唑（LMS）对骨折创伤后机体红细胞生物学行为的影响，为预防和治疗创伤后深静脉血栓的形成提供新的思路。方法选取30只成年健康雄性家兔随机分为两组（n=15）：创伤对照组（A组）与创伤用药组（B组）。麻醉后，两组家兔均于小转子下方3cm截骨并用钢板螺钉固定，其中A组不予处理，8组于术前30min按照24mg／kg肌肉注射LMS。所有家兔均于术前30min，术后30min、1d、4d、7d抽取血样，分别测定红细胞丙二醛含量；检测不同时间点红细胞I型补体受体花环率（RC3bRR）、红细胞免疫复合物花环率（RICR）、自然肿瘤红细胞花环率（NTERR），以及血流变性、红细胞刚性指数、聚集指数、变形指数等。结果红细胞免疫在术后30min、1d、4d RC3bRR、NTERRB组比A组同时相高，而RICRB组比A组同时相低，差异均有统计学意义（P〈0．05）；以上三项指标A组术后较术前差异有统计学意义（P〈0．05），B组术后较术前差异无统计学意义（P〉0．05）。红细胞脂质过氧化在术后30min、1d、4d红细胞中丙二醛均比术前高，同时B组比A组同时相低，差异均有统计学意义（P〈0．05）；A组术后较术前差异有统计学意义（P〈0．05），B组术后较术前差异无统计学意义（P〉0．05）。结论创伤能引起机体红细胞免疫功能降低，脂质过氧化增强，流变性变差；LMS可以明显改善创伤后红细胞生物学行为，即可能对于降低骨折创伤后深静脉血栓的形成提供新的思路。Objective To investigate the influence of levamisole （LMS） on the biological behavior of red blood cells （RBC） after fracture, in order to suggest a new strategy for prevention and therapy of traumatic deep venous thrombosis （DVT） . Methods Thirty male rabbits were divided randomly into 2 equal groups, control group A and experimental group B. After anesthesia, fractures were created 3 cm below the entotrochanter and then fixed with plates and screws in both groups. Blood samples were harvested from the 2 groups to analyze blood rheological characteristics respectively at 30 min before operation, 30 min, 1, 4 and 7 days after operation. Malondialdehyde （MDA）, rigid index, accumulation index and distortion index, C3b receptor rate （RC3bRR）, circulating immune complexes rate （RICR） and natural tumor erythrocyte rosette rate （NTERR） of RBCs were measured. Results RBC immunity： The rates of RC3BRR and NTERR in group B were higher than in the control group （group A）（ P 〈 0.05） at 30 min, I and 4 days after operation. However, the rate of RICR was higher in group A than in group B （ P 〈 0.05）. There were significant differences between pre- and post-operation in group A, but not in group B. RBC lipid peroxidafion： The postoperative MDA values of RBCs at 30 min, 1 and 4 clays in both groups were higher than the preoperative one. The differences were statistically significant （ P 〈 0.05 ） in group A, but not in group B. The MDA was lower in group B than in group A （ P 〈 0. 05）. Conclusions Trauma can weaken the RBC immune function, increase the lipid peroxidation, and worsen the blood rheological property. LMS can obviously improve the biological behavior of RBC, suggesting it may be useful in prevention and therapy of DVT after fracture.

关 键 词：免疫因子类 红细胞 静脉血栓形成 创伤和损伤 骨折 

分 类 号：R686[医药卫生—骨科学]