不同核心温度下劳力性热射病大鼠凝血功能障碍特征研究  

Characteristics of coagulation dysfunction in rats with exertional heatstroke at different core temperatures

作　　者：窦建林 宋景春[1] 余甜 吴阳 何龙平 钟林翠 林青伟 DOU Jian-lin;SONG Jing-chun;YU Tian;WU Yang;HE Long-ping;ZHONG Lin-cui;LIN Qing-wei(Intensive Care Unit,the 908th Hospital of Chinese PLA Logistical Support Force,Nanchang City’s Thrombosis and Hemostasis Laboratory,Nanchang 330002,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院重症医学科/南昌市血栓与止血学重点实验室,江西南昌330002

出　　处：《创伤与急危重病医学》2022年第2期92-96,共5页Trauma and Critical Care Medicine

基　　金：江西省卫健委科技计划(SKJP220204170,SKJP220204073)。

摘　　要：目的劳力性热射病常合并严重的凝血功能障碍,本研究旨在探讨劳力性热射病大鼠处于不同核心温度时凝血功能障碍的特征。方法选取SPF级SD大鼠25只,并完成遥测温度胶囊腹腔植入术。术后恢复1周后,将大鼠随机分为对照组(n=5)与模型组[40℃组(n=5)、41℃组(n=5)、42℃组(n=5)及43℃组(n=5)]。采用腹腔遥测温度胶囊监测大鼠核心体温,模型组大鼠均于温度40℃、相对湿度70%的环境下跑步,建立劳力性热射病模型,核心温度达到预定温度时即认为模型建立成功,记录建模成功时的跑步时间和距离。各组劳力性热射病模型大鼠在核心温度达标时,检测凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血小板计数、纤维蛋白原、凝血酶时间(TT)、血栓调节蛋白(TM)、凝血酶敏感蛋白-1(TSP-1)、血管性血友病因子(vWF)、纤溶酶原激活物抑制物-1(PAI-1)及血乳酸水平;对照组大鼠在模型组大鼠进行实验前采血并对上述相关指标进行检测。结果与对照组比较,核心温度40℃组大鼠的血小板计数开始明显降低,且随核心温度升高而下降,差异有统计学意义(P<0.05)。与对照组比较,核心温度41℃组大鼠的PT、APTT开始明显延长,并随核心温度升高而延长,差异有统计学意义(P<0.05)。43℃组大鼠的TT较对照组、40℃组、41℃组明显延长,差异有统计学意义(P<0.05)。40℃组、41℃组大鼠纤维蛋白原水平较对照组升高,差异有统计学意义(P<0.05)。与对照组比较,核心温度40℃组大鼠的vWF开始明显升高,且随核心温度升高而升高,差异有统计学意义(P<0.05)。与对照组比较,核心温度41℃组大鼠的TSP-1开始明显升高,并随核心温度升高而升高,差异有统计学意义(P<0.05)。与对照大鼠比较,核心温度42℃组大鼠TM、乳酸水平开始明显升高,并随核心温度升高而升高,差异有统计学意义(P<0.05)。43℃组大鼠PAI-1水平较对照组明显�Objective To investigate the status of coagulation function in rats with exertional heatstroke at different core temperatures.Methods Twenty-five SPF rats were implanted with remote sensing temperature capsule to monitor their core temperature.One week after the operation,the rats were randomly divided into control group(n=5)and model group[40℃group(n=5),41℃group(n=5),42℃group(n=5)and 43℃group(n=5)].The rats in model group were used to establish model of exertional heatstroke by running at a temperature of 40℃and relative humidity of 70%,and their core temperature were monitored by remote sensing temperature capsule.When the core temperature reached the predetermined temperature,the running time and distance were recorded.Coagulation assays were performed when the core temperature of model group reached the standard.Coagulation items were analyzed statistically including prothrombin time(PT),activated partial thromboplastin time(APTT),platelet count,fibrinogen,thrombin time(TT),thrombomodulin(TM),and thrombin-sensitive protein-1(TSP-1),von willebrand factor(vWF),plasminogen activator inhibitor-1(PAI-1)and lactic acid levels.The above indexes of the control group were detected before the experiment of the model group.Results Compared with the control group,the platelet count in the 40℃group began to decrease significantly,and decreased with the increase of core temperature(P<0.05).Compared with the control group,PT and APTT in 41℃group began to be significantly prolonged with the rising core temperature(P<0.05).Compared with the control group,40℃group and 41℃group,TT in the 43℃group was significantly prolonged(P<0.05).The levels of fibrinogen in the 40℃group and 41℃group were significantly higher than those in the control group(P<0.05).Compared with the control group,the level of vWF in the 40℃group began to increased significantly with the rising core temperature(P<0.05).Compared with the control group,the level of TSP-1 in the 41℃group was significantly increased,and gradually increas

关 键 词：劳力性热射病 核心温度 大鼠 凝血功能 内皮损伤 

分 类 号：R594.11[医药卫生—内科学]