血栓弹力图指导下抗结核药物对人凝血功能的直接影响:一项体外研究  

In vitro study of direct effect of anti-tuberculosis on blood coagulation under thromboelastography

作　　者：江山[1] 奚雷[2] 孙杨[1] JIANG Shan;XI Lei;SUN Yang(Department of Anesthesiology,Nanjing Chest Hospital,Brain Hospital Affiliated to Nanjing Medical University,Nanjing,Jiangsu 210019,China;Department of Thoracic Surgery,Nanjing Chest Hospital,Brain Hospital Affiliated to Nanjing Medical University,Nanjing,Jiangsu 210019,China)

机构地区：[1]南京市胸科医院/南京医科大学附属脑科医院(胸科院区)麻醉科,江苏南京210019 [2]南京市胸科医院/南京医科大学附属脑科医院(胸科院区)胸外科,江苏南京210019

出　　处：《临床肺科杂志》2022年第6期909-914,共6页Journal of Clinical Pulmonary Medicine

基　　金：南京医科大学校基金(No.NMUB2020230)。

摘　　要：目的应用血栓弹力图,观察异烟肼和利福平这两种抗结核药物对人全血凝血功能的直接影响。方法采用离体血模型,在采血抗凝管中加入0.1 mL药液行预处理,分别含0.9%的氯化钠(NS组),12μg异烟肼(I组),48μg利福平(R组),以及12μg异烟肼和48μg利福平(C组)。健康志愿者通过随机数字表法随机分至四组,每位志愿者采集1.9 mL血样,加入抗凝管中充分混匀,后行血栓弹力图检测。记录受试者的一般情况,比较血栓弹力图检测到的各组参数。结果最终纳入志愿者共64例,每组各16例。四组志愿者的一般情况比较,未见统计学差异(P>0.05)。血栓弹力图结果提示,Ⅰ组R时间长于NS组和R组(P<0.05);I组和C组K时间均长于NS组和R组(P<0.05);Ⅰ组和C组的α角度均小于NS组和R组(P<0.05);Ⅰ组和C组的MA值均小于NS组和R组(P<0.05);Ⅰ组和C组的G值和CI值均小于NS组和R组(P<0.05)。结论血栓弹力图提示,人离体血模型下,异烟肼、以及异烟肼联合利福平均会直接抑制人全血凝血功能,而利福平并未发现有直接影响。Objective To investigate the direct effect of anti-tuberculosis drugs on blood coagulation using thromboelastography(TEG).Methods Using isolated blood model,0.1 mL of 0.9%sodium chloride solution(the NS group),12μg isoniazid(the I group),48μg rifampin(the R group),and a mixture of 12μg isoniazid and 48μg rifampin(the C group)were added into blood collection tubes.Healthy volunteers were randomly divided into 4 groups,and blood samples(1.9 mL)were added into the prepared tubes for TEG test.The indexes of TEG were compared among the different groups.Results 64 volunteers were enrolled in the final study,16 cases in each group.There was no significance in demographic baseline data among all groups(P>0.05).The results of TEG showed R time was longer in the Ⅰ group than in the R group and the NS group(P<0.05).K time in the Ⅰ group and the C group was both longer than that in the R group and the NS group(P<0.05).αangle of the Ⅰ group and the C group was smaller than that of the R group and the NS group(P<0.05).The value of MA,G and CI was all lower in the Ⅰ group and the C group than in the R group and the NS group(P<0.05).Conclusion TEG in whole vitro model suggests that isoniazid,used alone or mixed with rifampin,could inhibit coagulation function directly,while rifampin does no direct effect on blood coagulation.

关 键 词：血栓弹力图 抗结核药物 凝血功能 

分 类 号：R969[医药卫生—药理学]