藻酸钙敷料的促凝血机制  

Hemostatic mechanism of calcium alginate dressing

作　　者：崔飞艳 王斌[1] 魏立[2] 王海涛[1] 陈豪[1] 初晓夏 王祯祯[1] 杨丽华[3] 

机构地区：[1]青岛大学医学院特种医学教研室,山东省青岛市266071 [2]解放军第401医院,山东省青岛市266071 [3]青岛大学医学院免疫学教研室,山东省青岛市266071

出　　处：《中国组织工程研究》2015年第47期7681-7686,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:藻酸钙敷料近年来被广泛应用于手术止血、外伤止血、鼻腔术后止血、穿刺部位止血等,但有关其止血机制的国内外研究较少。目的:初步探讨藻酸钙敷料的促凝血机制。方法:将人抗凝血分别滴加至藻酸钙敷料、纳吸棉与医用棉纱布上,室温静置2 min,扫描电镜下观察材料与血液的相互作用;在人红细胞悬液中分别加入藻酸钙敷料、纳吸棉与医用棉纱布,静置15 s,扫描电镜下观察材料与红细胞的相互作用;在人红细胞中分别加入10,5,2.5 g/L的藻酸钙敷料浸提液,观察作用30,60,120 min的红细胞沉降率;在人富血小板血浆中分别加入10,5,2.5 g/L的藻酸钙敷料浸提液,37℃孵育10 min,流式细胞仪检测CD62P阳性血小板百分率。结果与结论:藻酸钙敷料与抗凝血接触后可见致密的纤维蛋白网形成,其中网罗大量血细胞;纳吸棉组与医用棉纱布组仅见少量红细胞及血小板黏附。藻酸钙敷料与红细胞相互作用后可见红细胞变形,有伪足样改变,纳吸棉组与医用棉纱布组红细胞形态无变化。藻酸钙敷料浸提液呈剂量与时间依赖性提高红细胞沉降率,组间两两比较差异有显著性意义(P<0.01);藻酸钙敷料浸提液呈剂量依赖性提高CD62P阳性血小板百分率,组间两两比较差异有显著性意义(P<0.01)。表明藻酸钙敷料可通过释放钙离子、引起红细胞聚集和变形、活化血小板等促进止凝血过程。BACKGROUND：In recent years, calcium alginate dressing has been widely used in surgical hemostasis, traumatic hemostasis, postoperative nasal hemostasis and puncture site hemostasis,etc.; however, there are few reports on their hemostatic mechanisms. OBJECTIVE： To preliminarily study the hemostatic mechanism of calcium alginate dressing. METHODS： Human anticoagulant blood was respectively dropped on sodium alginate dressing, nasopore dressing and medical cotton gauze. After 2 minutes, the interaction between materials and blood was observed at the room temperature using scanning electron microscopy. Calcium alginate dressing, nasopore dressing and medical cotton gauze were added in human red blood cel suspensions respectively. After 15 minutes, theinteraction between materials and red blood cels was observed using scanning electron microscopy. The red blood cels were suspended by different concentrations （10, 5, 2.5 g/L） of alginate dressing extracts. The erythrocyte sedimentation rate was observed at different time points （30, 60, 120 minutes）. Platelets rich plasma was incubated with different concentrations （10, 5, 2.5 g/L） of alginate dressing extract at 37℃, then CD62P positive platelet percentage was measured by flow cytometry after 10 minutes of incubation. RESULTS AND CONCLUSION： Dense fibrin network was formed after calcium alginate dressing contacting with an anticoagulant. A large number of blood cels were recruited. There were only a smal amount of red blood cels and platelets adhesion in the nasopore dressing and medical cotton gauze groups. After the calcium alginate dressing interacting with red blood cels, red blood cel deformability was visible, with a pseudopodia-like change. The red blood cel morphology was unchanged in the nasopore dressing and medical cotton gauze groups. The calcium alginate dressing extract dose-dependently and time-dependently increased the red blood cels aggregation, comparative differences between groups was statisticaly significant（P 〈 0.01）.

关 键 词：生物材料 材料相容性 藻酸钙敷料 浸提液 枸橼酸钠 钙离子 红细胞 血小板 CD62P 

分 类 号：R318[医药卫生—生物医学工程]