抗菌药物对酒精性肝病创伤弧菌脓毒症大鼠凝血因子的影响  

Effect of antimicrobial agents on the coagulation factors of rats with alcohol-induced liver disease and Vibrio vulnificus sepsis

作　　者：洪广亮[1] 卢中秋[1] 郑仕包[1] 李萌芳[1] 董磊[2] 

机构地区：[1]温州医学院附属第一医院急诊科,325000 [2]温州医学院附属第一医院病理科,325000

出　　处：《浙江医学》2010年第7期1014-1017,共4页Zhejiang Medical Journal

基　　金：浙江省医学扶植重点建设学科计划（07-F04）,浙江省科技计划项目（2005C30009）

摘　　要：目的探讨抗菌药物对酒精性肝病大鼠创伤弧菌（VV）脓毒症凝血因子的影响。方法将制成酒精性肝病模型的60只SD大鼠随机分为酒精性肝病对照组（AC组）、酒精性肝病抗菌药物对照组（AA组）、酒精性肝病VV脓毒症模型组（AV组。共4组）和酒精性肝病VV脓毒症抗菌药物治疗组（AVA组，共4组），并设正常对照组（NC组），观察各组不同时点内血浆凝血因子纤维蛋白原（FIG）、凝血酶Ⅲ活性（AT：A）、组织型纤溶酶原激活物（t-PA）、纤溶酶原激活物抑制剂-1（PAI-1）和ALT、AST水平及其动态变化。结果AV组染菌后6、12、24h时的FIG水平均明显高于NC组和AC组；染菌后6、12、24h时的AT：A水平均较NC组和AC组显著降低；染菌后2、24h时的t-PA水平较NC组和AC组增高；染菌后2h时PAI-1水平较NC组和AC组增高。AVA组染菌后12、24h时的FIG水平均较NC组和AC组增高，6、12h时的FIG水平较同时点的AV组降低；染菌后12h时的AT：A水平均较NC组和AC组降低。但24h时的水平则较NC组、AC组和同时点的AV组增高；24h时的t-PA水平较同时点AV组降低；PAI-1水平和NC组、AC组和AV组的差异均无统计学意义。结论酒精性肝病大鼠VV脓毒症表现为持续加剧的高凝状态，早期伴有纤溶抑制，后期伴有继发性纤溶亢进，动态检测凝血因子可反应病情严重程度；头孢哌酮钠与乳酸左氧氟沙星联用有利于纠正VV脓毒症大鼠凝血系统的紊乱。Objective To investigate effects of antimicrobial agents on the coagulation factors of rats with alcohol-induced liver disease and Vibrio vulnificus sepsis. Methods Sixty SD rats with alcoholic liver disease were randomly divided into four groups including alcoholic liver disease control group （AC group）, alcoholic liver disease and antibiotic therapy control group （AA group）, VV sepsis with alcoholic liver disease group （AV group including 4 subgroups）, VV sepsis with alcoholic liver disease and antibiotic therapy group （AVA group, including 4 subgroups）. Six normal SD rats were used for normal control group （NC group）. The dynamic change of plasma coagulation factor fibrinogen （FIG）, thrombin III activity （AT： A）, tissue-type plasminogen activator （t-PA）, plasminogen activator inhibitor -1 （PAl-1） and ALT, AST in each group were observed at different time points. Results Compared with the control groups （NC and AC）, the level of FIG in the AV group increased markedly at 6h, 12h and 24h, while the level of AT：A decreased significantly at 6h, 12h, 24h; The level of t-PA increased markedly at 2h , 24h and PAl-1 increased markedly at 2h; The ratio （tPA/PAI-1） decreased significantly at 2h, but increased markedly at 24h. Compared with the control groups （NC and AC）,the levels of FIG in the AVA group increased at 12h, 24h and decreased at 6h, 12h compared with the AV group; The level of AT：A in the AVA group were lower than that in the control groups at 12h,but much higher than that in the control groups and the AV group at 24h. The level of t-PA in AVA group was obviously lower than AV at 24h. The differences of PAl-1 and the ratio （tPA/PAI-1） between AVA group and AV group, the control groups were not statistically significant. Conclusion Hypercoagulation appears in rat model of alcoholic liver disease with vibrio vulnificus sepsis accompanied with fibrinolysis inhibition at early stage and secondary hyperfibrinolysis at last stage. The levels of coagulation

关 键 词：酒精性肝病 脓毒症 创伤弧菌 凝血因子 抗菌药物 

分 类 号：R187.4[医药卫生—流行病学]