P2Y12受体抑制剂抗血小板聚集对脓毒症凝血功能影响的研究  

Effect of anti platelet aggregation with P2Y12 receptor inhibitor on coagulation function in sepsis

作　　者：曲凯丽 罗前程[2] 许磊[2] 杭敏[2] 郭东风[2] Qu Kaili;Luo Qiancheng;Xu Lei;Hang Min;Guo Dongfeng(Postgraduate Training Base,Gongli Hospital of Pudong New Area,Shanghai City,Ningxia Medical University,Shanghai 200135;Emergency Medicine,Gongli Hospital of Pudong New Area,Shanghai City,Shanghai 200135)

机构地区：[1]宁夏医科大学上海市浦东新区公利医院研究生培养基地,上海200135 [2]上海市浦东新区公利医院急诊医学科,上海200135

出　　处：《中国社区医师》2021年第14期4-5,共2页Chinese Community Doctors

基　　金：上海市浦东新区卫生系统优秀青年医学人才培养项目(PWRq2017-09);上海市卫生和健康委员会科研项目(201640405);上海市浦东新区卫生系统重点专科建设项目(PWZzk2017-05)。

摘　　要：目的:利用脂多糖(LPS)建立小鼠脓毒症模型,探讨P2Y12受体抑制剂(氯吡格雷)对脓毒症凝血功能的影响。方法:将24只小鼠随机等分为四组,分别为空白对照组、LPS组、氯吡格雷LPS诱导组和LPS氯吡格雷治疗组。通过单次腹腔注射LPS(15 mg/kg)0.1 mL/只制备小鼠脓毒症模型,氯吡格雷灌胃(15 mg/kg)1 mL/只,以首次腹腔注射记为“0 h”分别在4 h、12 h、24 h、48 h采血进行血小板数量(PLT)、血小板平均体积(MPV)、白细胞数量(WBC)及凝血纤溶指标水平检测。结果:LPS氯吡格雷治疗组4 h时点MPV水平高于LPS组,且凝血酶-抗凝血酶复合物(TAT)水平低于LPS组,差异有统计学意义(P<0.05)。氯吡格雷LPS诱导组各时点PLT和WBC水平均高于LPS组,4 h MPV水平高于LPS组,24 h TAT水平低于LPS组,4 h和24 hD-二聚体(DD)水平均低于LPS组,4 h组织纤维蛋白(原)降解产物(FDP)水平低于LPS组,差异均有统计学意义(P<0.05)。结论:P2Y12受体抑制剂氯吡格雷可通过抑制血小板聚集改善脓毒症凝血、纤溶功能异常。Objective:To investigate the effect of P2Y12 receptor inhibitor(clopidogrel)on coagulation function in sepsis with establishment of mouse sepsis model by lipopolysaccharide(LPS).Methods:24 mice were randomly divided into four groups:blank control group,LPS group,clopidogrel LPS induction group and LPS clopidogrel treatment group.The sepsis model was established by single intraperitoneal injection of LPS(15 mg/kg)of 0.1 mL/case,intragastric administration of clopidogrel(15 mg/kg)0.1 ml/case,the first intraperitoneal injection was recorded as"0 hour",blood samples were collected at 4 hours,12 hours,24 hours and 48 hours for PLT,MPV,WBC,coagulation and fibrinolysis index level testing.Results:In the LPS clopidogrel treatment group,the MPV level at 4 hours was higher than that in the LPS group,and the TAT level was lower than that in the LPS group,the difference was statistically significant(P<0.05).In the clopidogrel LPS induction group,the levels of PLT and WBC at all time points were higher than those in the LPS group,the level of MPV at 4 hours was higher than that in the LPS group,the level of TAT at 24 hours was lower than that in the LPS group,the level of DD at 4 hours and 24 hours was lower than that in the LPS group,and the level of FDP at 4 hours was lower than that in the LPS group,the difference was statistically significant(P<0.05).Conclusion:P2Y12 receptor inhibitor clopidogrel can improve coagulation and fibrinolysis in sepsis by inhibiting platelet aggregation.

关 键 词：P2Y12受体抑制剂 氯吡格雷 血小板 脓毒症 

分 类 号：R459.7[医药卫生—急诊医学]