生脉饮对劳力性热射病大鼠凝血功能障碍的预防作用  

Preventive effect of Shengmaiyin on exertional heatstroke induced coagulopathy in rats

作　　者：窦建林 何龙平 钟林翠 林青伟 罗竹青 宋景春 Dou Jian-Lin;He Long-Ping;Zhong Lin-Cui;Lin Qing-Wei;Luo Zhu-Qing;Song Jing-Chun(Jiangxi University of Traditional Chinese Medicine,Nanchang,Jiangxi 330004,China;Department of Critical Care Medicine,the 908th Hospital of Joint Logistics Support Force of Chinese PLA/Nanchang Key Laboratory of Thrombosis and Hemostasis,Nanchang,Jiangxi 330002,China)

机构地区：[1]江西中医药大学,江西南昌330004 [2]解放军联勤保障部队第908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：《解放军医学杂志》2023年第7期790-796,共7页Medical Journal of Chinese People's Liberation Army

基　　金：江西省卫健委科技计划项目(202131115,202131123)。

摘　　要：目的探讨生脉饮口服液对劳力性热射病(EHS)大鼠凝血功能障碍的预防作用。方法SPF级雄性SD大鼠15只,均完成遥测温度胶囊植入术,术毕恢复1周后随机分为假手术组、热射病组、生脉饮组,每组5只。生脉饮组大鼠提前给予生脉饮0.02 ml/(g.d)灌胃5 d,热射病组及生脉饮组大鼠均在人工气候舱内(温度40℃,相对湿度70%)跑步,记录核心温度达到42℃时的运动时间及距离。采集3组大鼠血液,检测并比较其凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血小板计数(PLT)及血乳酸(Lac)、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)水平;观察3组大鼠肝、肾、肺、肠、心脏组织的病理改变。结果生脉饮组大鼠核心温度达到42℃时的运动距离及运动时间均较热射病组明显延长[(456.3±92.3)m vs.(282.8±87.5)m,P<0.05;(36.3±6.3)minvs.(21.7±7.0)min,P<0.05]。与对照组比较,热射病组大鼠PT及APTT均明显延长[(13.8±0.7)s vs.(9.9±0.7)s,P<0.05;78.3(36.0,120.0)s vs.19.0(16.6,22.5)s,P<0.05],Lac明显升高[(10.5±2.0)mmol/Lvs.(4.0±0.7)mmol/L,P<0.05],PLT明显降低[(590.3±80.2)×10^(9)/Lvs.(1750.3±283.0)×10^(9)/L,P<0.05],血浆TM、vWF、TSP-1及PAI-1水平均明显升高[2.1(1.8,2.7)ng/mlvs.1.6(1.5±1.7)ng/ml,P<0.05;(953.1±60.0)p g/m lv s.(462.3±37.0)p g/m l,P<0.05;(78.1±19.8)n g/m lv s.(59.3±12.0)n g/m l,P<0.05;(1945.7±74.5)ng/mlvs.(1487.6±259.1)ng/ml,P<0.05]。与热射病组比较,生脉饮组大鼠APTT明显缩短[36.6(31.1,46.1)svs.78.3(36.0,120.0)s,P<0.05],PLT明显增高[(980.5±302.4)×10^(9)/Lvs.(590.3±80.2)×10^(9)/L,P<0.05],血浆TM、vWF、PAI-1水平均明显降低[1.7(1.6,1.8)ng/ml vs.2.1(1.8,2.7)ng/ml,P<0.05;(701.6±32.0)pg/ml vs.(953.1±60.0)pg/ml,P<0.05;(1582.8±71.6)ng/mlvs.(1945.7±74.5)ng/ml,P<0.05]。热射病组大鼠的肝、肾、肺、肠、心脏病理学检查均可见血栓形成,生脉饮组大鼠病理学检查未见明显血Objective To explore the preventive effect of Shengmaiyin on coagulation dysfunction of exertional heatstroke(EHS)in rat.Methods Fifteen SPF male SD rats were randomly divided into sham operation group,heatstroke group,and Shengmaiyin group(5 each group)after implantation of telemetry temperature capsule for one week.Rats in Shengmaiyin group were given Shengmaiyin at 0.02 ml/(g·d)by gavage for five days.The rats in the heatstroke group and Shengmaiyin group ran in the artificial climate chamber(40℃,70%humidity).The running time and distance were recorded when the core temperature reached 42℃.Blood samples from the three groups of rats were collected to evaluate prothrombin time(PT),activated partial thromboplastin time(APTT),platelet count(PLT),blood lactic acid(Lac),thrombomodulin(TM),thrombin sensitive protein-1(TSP-1),von Willebrand factor(vWF)and plasminogen activator inhibitor-1(PAI-1).Pathological changes were examined in the liver,kidney,lung,intestine,and heart.Results When the core temperature reached 42℃,the running distance and running time of rats in the Shengmaiyin group were significantly longer than those in the heatstroke group[(456.3±92.3)m vs.(282.8±87.5)m,P<0.05;(36.3±6.3)min vs.(21.7±7.0)min,P<0.05].Compared with the control group,PT and APTT in the heatstroke group were significantly prolonged[(13.8±0.7)s vs.(9.9±0.7)s,P<0.05;78.3(36.0,120.0)s vs.19.0(16.6,22.5)s,P<0.05],Lac was significantly increased[(10.5±2.0)mmol/L vs.(4.0±0.7)mmol/L,P<0.05],and PLT decreased significantly[(590.3±80.2)×10^(9)/L vs.(1750.3±283.0)×10^(9)/L,P<0.05],plasma TM,vWF,TSP-1,and PAI-1 levels increased significantly[2.1(1.8,2.7)ng/ml vs.1.6(1.5±1.7)ng/ml,P<0.05;(953.1±60.0)pg/ml vs.(462.3±37.0)pg/ml,P<0.05;(78.1±19.8)ng/ml vs.(59.3±12.0)ng/ml,P<0.05;(1945.7±74.5)ng/ml vs.(1487.6±259.1)ng/ml,P<0.05].Compared with the rats in heatstroke group,the APTT of the rats in Shengmaiyin group was significantly shortened[36.6(31.1,46.1)s vs.78.3(36.0,120.0)s,P<0.05],and the PLT elevated significantly[

关 键 词：生脉饮 劳力性热射病 凝血功能障碍 大鼠 预防 

分 类 号：R594.11[医药卫生—内科学]