对氧磷酶-2通过内皮组织因子调节失血休克患者凝血激活的机制研究  

The mechanism of thrombin activation in patients with hemorrhagic shock was regulated by.paraonase 2(PON2)through endothelial tis-sue factors

作　　者：明绘 贵敏 王华乔 张敏 MING Hui;GUI Min;WANG Huaqiao;ZHANG Min(Emergency Department,Hubei 672 Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan Hubei,430079,China)

机构地区：[1]湖北六七二中西医结合骨科医院急诊科,湖北武汉430079

出　　处：《中国急救复苏与灾害医学杂志》2021年第2期183-186,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：武汉市卫生计生委科研项目(编号:WZ19C34)。

摘　　要：目的探究对氧磷酶-2(PON2)通过内皮组织因子调节失血休克患者凝血激活的机制。方法大鼠腹腔注射戊巴比妥钠麻醉后,采用等血容量失血方式形成休克-复苏组模型,受试动物分为生理盐水复苏组和对氧磷酶-两组复苏组。各大鼠凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)和凝血酶原时间(PT-INR)值在组内和组间进行比较;对血清中TNF-α、IL-1β和HMGB1因子含量进行检测,并对各因子基因蛋白含量进行测定,最后通过组织切片HE染色观察对比组织切片中的炎症细胞浸润数量。结果对照组治疗前后凝血五项中,FIB、PT、APTT和TT四者有显著性差异;对照组与治疗组治疗后凝血5项差值比较,FIB、PT、APTT和TT有显著性差异(P<0.05);氧磷酶-两组复苏组与对照组治疗前后凝血5项,差值比较有统计学意义(P<0.05)。不同休克复苏液对血清中TNF-α、IL-1β和HMGB1含量有显著影响(P<0.05),对氧磷酶-2对血清中TNF-α、IL-1β两种炎症因子有抑制作用;对氧磷酶-2处理后的小鼠血液组织中IL-12B TNF-α蛋白表达减少;HMGB1却较对照组高,蛋白表达提高;通过肝脏组织HE染色后病理显微照片观察发现,对氧磷酶-两组肝纽织肝索结构基本清晰。结论对氧磷酶-2通过内皮组织因子调节失血休克患者凝血激活,从而降低凝血功能紊乱,加快痊愈。Objective To explore the mechanism of P0N2 regulating coagulation activation in patients with hemor-rhagic shock.Methods After intraperitoneal injection of pentobarbital steel,mices were treated with iso-volume blood loss to form the shock and resuscitation group model.The prothrombin time(PT),activated partial prothrombin time(APTT),thrombin time(TT),fbrinogen(FIB)and prothrombin time(PT-INR)values of each rat were compared within and between groups.The serum levels of TNF-α、IL-1βand HMCB1 were detected,and the protein content of each factor gene was determined.At last,the number of inflammatory cell infiltration in tissue sections was ob-served and compared through HE staining of tissue sections.Results There were significant differences in FIB,Pt,APTT and TT between the control group and the treatment group before and after treatment;there were significant differences in FIB,P,APTT and TT between the control group and the treatment group after treatment(P<0.05);there were significant differences in the five coagulation differences between the recovery group and the control group before and after treatment(P<0.05).Different shock fluid had significant effect on the content of TNF-α,IL-1βand HMGB1 in serum(P<0.05),and had inhibitory effect on the two inflammatory factors of TNF-αand IL-1βin serum;it had decreased the expression of IL-12B TNF-αin the blood tissue of mice lreated with oxyphospha-tase-2;HMGB1 was higher than that of the control group,and the expression of protein was increased;after he stain-ing of liver tissue,the pathological micrograph was observed It was found that the structure of hepatic cord was basi-cally clear in p-oxonase-2 group.Conclusion Paraoxonase-2 regulates the activation of coagulation in patients with hemorrhagic shock through endothelial tissue factor,so as to reduce the disorder of coagulation function and acceler-ate the recovery.

关 键 词：对氧磷酶-2 内皮组织因子 失血休克 凝血激活 机制研究 

分 类 号：R441.9[医药卫生—诊断学]