水蛭素对脓毒症早期大鼠纤溶功能的影响  

Effects of hirudin on fibrinolytic function in rats with early sepsis

作　　者：陈明 龚海林 胡志华[1] 夏冰 张念清[1] CHEN Ming

机构地区：[1]南昌市洪都中医院,江西南昌330000

出　　处：《中医临床研究》2024年第22期60-63,共4页Clinical Journal Of Chinese Medicine

基　　金：江西省卫生计生委科技计划(202311316)(202311317)。

摘　　要：目的:观察水蛭素对脓毒症早期大鼠纤溶功能的影响。方法:将45只大鼠随机分为假手术组、盲肠结扎组和水蛭素组,每组15只。同时各组均随机抽取10只大鼠用于观察24 h生存情况。术后6 h和12 h时间点取血标本及病理组织,检测抗凝血酶Ⅲ(AntithrombinⅢ,ATⅢ)、纤维蛋白原(Fibrinogen,FIB)、纤溶酶原(Plasminogen,PLG)、纤溶酶抑制剂(Plasmin Inhibitor,PI)、D-二聚体和纤维蛋白原降解产物(Fibrin Degradation Products,FDP)水平。结果:术后24 h,假手术组、模型组和水蛭素组大鼠的存活率分别为100%、40%和80%。与假手术组相比较,盲肠结扎组和水蛭素组大鼠的FIB水平在盲肠结扎穿孔术后12 h明显升高,且水蛭素组大鼠的FIB水平较盲肠结扎组更高(P<0.05)。盲肠结扎组和水蛭素组术后6 h和12 h的ATⅢ较假手术组均明显下降(P<0.05),且盲肠结扎组12 h时的ATⅢ较水蛭素组更低(P<0.05)。盲肠结扎组和水蛭素组大鼠术后12 h的PLG较假手术组明显降低(P<0.05)。与盲肠结扎组相比较,水蛭素组和假手术组大鼠12 h时的PI明显更低(P<0.05)。与盲肠结扎组相比较,假手术组和水蛭素组大鼠的FDP水平均明显更低(P<0.05)。盲肠结扎组大鼠的肠上皮细胞坏死及水肿情况较水蛭素组更重,且炎症细胞浸润更明显。结论:水蛭素可以调节促纤溶及抗纤溶的力量并增强脓毒症早期的抗凝及抗炎作用,从而改善脓毒症早期纤溶功能。Objective: To investigate the effect of hirudin on fibrinolytic function in rat with early sepsis. Methods: We randomly divided 45 healthy rat into a sham operation(SO) group, a caecal ligation puncture(CLP) group, and an hirudin(HI) group. Ten rats were randomly selected from each group for 24-hour survival observation. Blood samples and pathological tissues were collected at 6 and 12 hours after surgery. Antithrombin Ⅲ, fibrinogen, plasminogen, plasmin Inhibitor, d-dimer and fibrin degradation products were tested at 6 hours and 12 hours after operation. Results: After 24 hours of surgery, the survival rates of rats in the SO group, CLP group, and HI group were 100%, 40% and 80%, respectively. The FIB was significantly increased at 12 hours after operation in the SO group as compared with that in the CLP group and HI group(P<0.05), but that was remarkably higher in the HI group than the CLP group(P<0.05). The AT Ⅲ was significantly decreased at 6 hours and 12 hours after operation in the CLP and HI group as compared with that in the SO group(P<0.05), and that was remarkably lower at 12 hours after operation in the CLP group than the HI group(P<0.05). The PLG was significantly decreased at 12 hours after operation in the CLP group and HI group than the SO group(P<0.05). The PI was significantly decreased at 12 hours after operation in the SO and HI group than the CLP group(P<0.05). The FDP was significantly decreased at 6 hours and 12 hours after operation in the SO and HI group than the CLP group(P<0.05). Intestinal mucosal epithelial necrosis, interstitial edema, and inflammatory cell infiltration were significantly reduced more in the CLP group than the HI group. Conclusion: Hirudin can regulate profibrinolysis and anti-fibrinolysis and enhance the anticoagulant and anti-inflammatory effect in the early stages of sepsis, which can improve fibrinolytic function.

关 键 词：水蛭素 脓毒症 纤溶 试验大鼠 

分 类 号：R284[医药卫生—中药学]