不同抗凝药对血液灌流脓毒症兔动物模型的比较研究  

A comparative study of different anticoagulants effects on hemoperfusion in rabbit sepsis model

作　　者：车勇[1] 王斌[1] 纪国业[1] 张建[1] 

机构地区：[1]南方医科大学珠江医院儿科,广东广州510282

出　　处：《安徽医药》2012年第9期1232-1236,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的比较3种不同抗凝药对血液灌流脓毒症兔动物模型的作用。方法采用盲肠结扎穿孔法建立脓毒症兔动物模型,分为应用抗凝剂进行血液灌流的肝素组、枸橼酸组、水蛭素组和不应用抗凝剂血液灌流的手术组以及健康兔的假手术组,对各组造模前及灌流的0、10、30、601、20 min各时间点进行检测凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)。结果枸橼酸组和水蛭素组均无皮肤黏膜出血以及手术创口渗血,滤器无凝血;肝素组有1只手术创口渗血和1只眼睑黏膜出血,滤器无凝血;各药物组之间的动物生存时间无统计学差异。手术组的PT、APTT、TT和FIB明显低于假手术组(P<0.001),灌流过程中灌流器均堵塞导致蠕动泵无法转动,灌流时间为(44.45±13.27)min。灌流开始后随着灌流时间的延长,各灌流组检测指标值均逐渐下降,至灌流结束后(120 min),肝素组的各检测指标值下降最快,水蛭组的各检测指标值下降最平缓。结论在血液灌流中应用各抗凝药均能在一定程度上改善凝血障碍,枸橼酸作用平稳且无出血事件,安全有效。Objective To compare the effect of three different anticoagulants on hemoperfusion in rabbit sepsis model. Methods Rabbit sepsis model induced by cecal ligation and puncture（CLP） was prepared. These rabbits were randomly divided into heparin group, citric acid group, hirudin group, which applied corresponding anticoagulant, no anticoagulant control group, which was given hemoperfusion without anticoagulant, and normal control group. The Prothrombin time （PT）, partial thromboplastin time （APTT）, thrombin time （TT）, and fibrinogen（FIB） of the two control groups and the three hemoperfusion groups were observed when the experiment had begun for 10, 30,60 and 120 min. Results Citric acid group and hirudin group had no hemorrhage of skin mucous membrane or operation wound, while heparin group had 2 cases of hemorrhage,in which one was of skin mucous membrane and the other was of operation wound. All the groups had no blood clotting in filtrum. There was no difference in the live time of rabbits among all the drug groups （ P 〉 0.05 ）. PT, APTT, TT and FIB of no anticoagulant control group were obviously lower than those of normal control group （P 〈 0. 001 ）. The hemoperfusion failed because of the blockage of apparatus in no anticoagulant control group, and the time of hemoperfusion was only （44.45 ± 13.27） minutes. Ten minutes after hemoperfusion, PT, APTT, TT and FIB of heparin group, citric acid group, and hirudin group were significantly higher than those of the two control groups（ P 〈 0. 001 ）. All the targeted values were reduced along with the time of hemoperfusion until the end of hemoperfusion（ 120 min later） when all the targeted values observed in heparin group and citric acid group descended to the level close to that of normal control group, while those of hirudin group were much higher than those of normal control group（P 〈 0.05）. Conclusion Application of heparin, citric acid, and hirudin in hemoperfusion can ameliorate coagulation disorder to some degr

关 键 词：抗凝药 血液灌流 脓毒症 兔动物模型 比较研究 

分 类 号：R459.7[医药卫生—急诊医学] R-332[医药卫生—治疗学]