创伤大鼠模型实施治疗性血浆输血后凝血酶生成和纤维蛋白原水平与出血量的关系  

Relationship between thrombin generation and fibrinogen level and bleeding volume after therapeutic plasma transfusion in trauma rat model

作　　者：杨皓莹 张军 李玖平 YANG Hao-ying;ZHANG Jun;LI Jiu-ping(Department of Blood Transfusion,3201 Hospital,Hanzhong Shaanxi 723000,China;Department of Laboratory Medicine,3201 Hospital,Hanzhong Shaanxi 723000,China)

机构地区：[1]三二〇一医院输血科,陕西汉中723000 [2]三二〇一医院检验科,陕西汉中723000

出　　处：《临床和实验医学杂志》2022年第14期1461-1465,共5页Journal of Clinical and Experimental Medicine

基　　金：陕西省重点研发计划项目-一般项目(编号:2021SF-044)。

摘　　要：目的探讨创伤大鼠模型实施治疗性血浆输血后凝血酶生成和纤维蛋白原水平与出血量的关系。方法取40只雄性Sprague Dawley大鼠用于实验研究,将其中20只按照随机数字表法分为对照组(n=10)和血浆治疗组(n=10),剩余20只用于制备血液制品。对照组在颈静脉导管中接受5 mL磷酸盐缓冲液,血浆治疗组大鼠接受血浆输血治疗,输血速度设定为8.0 mL/h,平均动脉压达到60 mmHg 5 min后,停止输血。评估两组大鼠伤后60 min腹膜出血量,分别在输血后15、30、45、60 min评估大鼠的动脉血气。通过旋转血栓弹力图测量大鼠凝血参数。通过全自动凝血分析仪检测大鼠凝血酶原生成时间和纤维蛋白原水平。通过酶联免疫吸附试验检测大鼠血清白细胞介素(IL)-6、IL-8水平,并取外周血进行白细胞计数。通过苏木精和伊红染色对组织病理学进行评估,并进行病理学评分。结果输血后15 min两组大鼠腹膜出血量比较差异无统计学意义(P>0.05),输血后30、45、60 min,血浆治疗组腹膜出血量较对照组减少,差异均有统计学意义(P<0.05)。大鼠输血后15、30、45、60 min,血浆治疗组大鼠血压较对照组升高,差异均有统计学意义(P<0.05)。血浆治疗组最大凝块硬度和α角较对照组增加,血浆治疗组凝血时间较对照组减少,差异均有统计学意义(P<0.05)。血浆治疗组白细胞较对照组升高,IL-6、IL-8水平较对照组降低,差异均有统计学意义(P<0.05)。血浆治疗组凝血酶原生成时间较对照组缩短,纤维蛋白原水平较对照组增加,差异均有统计学意义(P<0.05)。血浆治疗组肝损伤评分、肺损伤评分和肾损伤评分较对照组降低,差异均有统计学意义(P<0.05)。结论血浆作为创伤大鼠复苏的辅助手段可以提高血小板驱动的止血效果,降低纤维蛋白原水平和炎症反应,同时不会加重器官损伤。Objective To investigate the relationship between thrombin generation and fibrinogen level and bleeding volume after therapeutic plasma transfusion in trauma rat model.Methods Forty male Sprague Dawley rats were used for the experimental study and 20 of them were randomly assigned to a control group(received 5 mL PBS in the jugular catheter,n=10)and plasma treatment group(n=10)according to the random number table method,and the remaining 20 were used to prepare blood products.The control group was received 5 mL PBS in the jugular catheter,the plasma treatment group was received plasma blood transfusion treatment,the blood transfusion rate was set at 8.0 mL/h,and the blood transfusion was stopped after MAP reached 60 mmHg for 5 min.The amount of peritoneal hemorrhage was evaluated 60 minutes after blood transfusion and the arterial blood gas of the rats was evaluated at the 15,30,45 and 60 minutes after the blood transfusion.Coagulation parameters in rats were measured by rotational thromboelastometry.The generation time of prothrombin and the level of fibrinogen in rats were detected by automatic coagulation analyzer.Serum levels of interleukin(IL)-6 and IL-8 were detected by enzyme-linked immunosorbent assay,and peripheral blood was collected for white blood cell count.Histopathology was assessed by hematoxylin and eosin staining,and pathology scoring was performed.Results There was no difference in the amount of peritoneal hemorrhage between the two groups at 15 min after the blood transfusion(P>0.05).At 30,45 and 60 min after the blood transfusion,the amount of peritoneal hemorrhage in the plasma treatment group was lower than that in the control group,the differences were statistically significant(P<0.05).At 15,30,45 and 60 min after blood transfusion,the blood pressure of the rats in the plasma treatment group was higher than that in the control group,the differences were statistically significant(P<0.05).Compared with the control group,the maximum clot hardness andαangle in the plasma treatment group incre

关 键 词：创伤大鼠 血浆输血 凝血酶 纤维蛋白原 

分 类 号：R641[医药卫生—外科学]