红细胞微粒的促凝血性质与小鼠急性肺损伤的关系  

Relationship between procoagulant properties of red blood cell-derived microparticles and acute lung injury in mice

作　　者：朱跃跃 卞茂红[1] 谢如锋[3] Zhu Yueyue;Bian Maohong;Xie Rufeng(Dept of Blood Transfusion,The First Affiliated Hospital of Anhui Medical University,Hefei 230022;Dept of Blood Transfusion,Lu an Civily Hospital,Lu an 237000;Shanghai Institute of Blood Transfusion,Shanghai Blood Center,Shanghai 200051)

机构地区：[1]安徽医科大学第一附属医院输血科,合肥230022 [2]六安世立医院输血科,六安237000 [3]上海市血液中心血液工程学科,上海200051

出　　处：《安徽医科大学学报》2020年第1期89-94,共6页Acta Universitatis Medicinalis Anhui

基　　金：上海市自然科学基金(编号:15ZR1438300)

摘　　要：目的研究红细胞微粒(RMPs)的促凝血性质以及此性质与小鼠急性肺损伤的关系。方法 RMPs经过分离纯化和计数,然后检测加入去除微粒前后的红细胞上清液及不同浓度RMPs的去微粒血浆的活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)及凝血酶生成实验。动物实验中用ELISA法测小鼠肺泡灌洗液凝血酶-抗凝血酶复合物(TATc)、纤溶酶原(PLG)及纤溶酶原激活物抑制因子1(PAI-1)含量。取注射3×10~7个RMPs数目的实验组及空白对照组小鼠右肺组织进行组织学观察。结果随着储存时间的延长,RMPs的数量逐渐增加。随着加入RMPs浓度的增高,其去微粒血浆的APTT值略有下降,而PT值没有明显变化。加入红细胞上清及一定浓度范围的RMPs,可以不同程度上缩短延迟时间和达峰时间,而凝血酶生成潜力和峰值都有相当大程度的升高,并具有浓度依赖关系。与对照组相比,注射RMPs的小鼠肺泡灌洗液的TATc明显增加且肺泡组织炎症反应加剧、促凝机制增强。结论随着储存时间延长,RMPs数目显著增加,RMPs可以促进凝血酶的生成从而促进系统性凝血,这可能与引发输血相关急性肺损伤(TRALI)相关。Objective To investigate the procoagulant properties of red blood cell microparticles(RMPs) and the relationship between this property and acute lung injury in mice. Methods RMPs were isolated, purified and counted,and then the contents of the activated partial prothrombin time(APTT), prothrombin time(PT) and thrombin generation test were detected in the plasma of red cell supernatant under the circumstances before and after the removal of the microparticles and different concentrations of RMPs. In animal experiments,the levels of thrombin-antithrombin complex, plasminogen and plasminogen activator inhibitor-1 in mouse alveolar lavage fluid were measured by ELISA.Histological observation of right lung tissue in the experimental group injected with 3×10~7RMPs and the control group was conducted. Results The number of RMPs increased gradually with the prolongation of storage time.As the concentration of RMPs added increased, the APTT value of the degranulated plasma decreased slightly, while the PT value did not change significantly.When erythrocyte supernatant and RMPs with a certain range of concentrations were added to the plasma, the lag time and tt-peak could be shortened to some extent, while the peak and ETP were increased significantly with a concentration dependent manner. Compared with the control group, the TATc of BALF was significantly increased in the experimental group injected with 3×10~7 RMPs, and the alveolar tissue inflammation was intensified and the coagulation promoting mechanism was enhanced. Conclusion As the storage time increases, the number of RMPs increases significantly. RMPs can promote thrombin generation and thereby promote systemic coagulation, which may be related to the transfusion-related acute lung injury(TRALI).

关 键 词：红细胞微粒 凝血 活化部分凝血酶原时间 凝血酶生成 输血相关急性肺损伤 

分 类 号：R446.113[医药卫生—诊断学] R457.13[医药卫生—临床医学]