孕兔羊水栓塞补体C3a、凝血功能的研究  

Study on complement C3a and coagulation function in amniotic fluid embolism of pregnant rabbits

作　　者：龙艳丽[1] 胡勇[2] 余舰[2] 张丽娟[3] 杨阳[3] 

机构地区：[1]贵州省人民医院病理科,贵州贵阳550002 [2]遵义医学院附属医院司法医学鉴定中心,贵州遵义563099 [3]遵义医学院法医学系,贵州遵义563099

出　　处：《遵义医学院学报》2015年第2期164-167,共4页Journal of Zunyi Medical University

基　　金：贵州省科学技术基金资助项目(NO:黔科合J字[2012]2358)

摘　　要：目的通过孕兔羊水栓塞动物模型测定凝血功能、补体C3a的含量以及补体C3a在肺组织中的表达,初步探索羊水栓塞(AFE)的发病机制。方法健康妊娠晚期孕兔随机分3组(对照组、羊水组、羊水胎粪组),暴露子宫抽取羊水、胎粪。按2.5 m L/Kg注入自体羊水、羊水胎粪混合液(羊水原液与胎粪按质量比配成1%混合液)入血,对照组注入等剂量生理盐水。注射30 min后取血分别用血凝仪测凝血功能(凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB))及ELISA法测血浆补体C3a含量。取血后10%KCl处死孕兔,取孕兔双肺做病理学检查。结果1补体C3a浓度:羊水组、羊水胎粪组补体C3a含量降低(P<0.05);2凝血功能检查结果:PT、APTT、TT羊水组、羊水胎粪组延长(P<0.05),FIB羊水组、羊水胎粪组降低(P<0.05)。结论 1发生AFE时补体C3a含量降低,说明补体系统被激活,消耗补体成分发生类过敏反应;2AFE时PT、TT、APTT均延长,FIB降低,说明AFE时有发展为DIC的趋势。Objective To determine the coagulation function and complement C3a content in amniotic fluid em- bolism of pregnant rabbit model and complement C3a expression in lung tissue and explore the pathogenesis of amniotic fluid Embolism. Methods Healthy trimester pregnant rabbits were randomly divided into the control, amniotic fluid and meconium groups. After the uterus exposure, the amniotic fluid and meconium were extrac- ted. Rabbits received autologous amniotic fluid and meconium mixture （2.5 ml/kg） at the quality ratio of meco- nium and amniotic liquid matched into 1% mixture along the ear vein injection, while the control group was giv- en the volume - matched saline. Thirty minutes after injection, the prothrombin time （PT） , the activated partial thromboplastin time （ AFFF）, the thrombin time （TF） and fibrinogen （ FIB ） were measured by coagulometer. Serum complement C3a content was detected by ELISA. The pathological examination of pregnant rabbit lungs was performed. Results The complement C3a level in amniotic fluid and meconium groups was lower than that in the control group. Compared with the control group, PT, Atilt and TT in amniotic fluid and meconium groups were prolonged and FIB in amniotic fluid and meconium groups was decreased. Conclusion 1 ） In amniotic fluid embolism, the complement C3a was reduced, suggesting that the complement system is activated and the comple- ment component is consumed and anaphylactoid reaction occurs. 2 ） In amniotic fluid embolism, PT, TT and AFFF are prolonged and FIB is decreased, suggesting that amniotic fluid embolism might develoo to DIC.

关 键 词：羊水栓塞 凝血功能 补体C3a 免疫组织化学染色 类过敏反应 

分 类 号：R714.46[医药卫生—妇产科学]