大鼠失血性休克继发凝血活化的实验治疗论文.docVIP

　　大鼠失血性休克继发凝血活化的实验治疗论文 王晓蓉 潘景业 朱椰凡 陈洁 王明山 王卫 全世超 唐敏 【摘要】 为了探讨不同复苏液对失血性休克大鼠凝血功能的影响和可能机制，将50只SD大鼠随机分为5组：对照组、假手术组、休克组、复苏1组（输林格液）和复苏2组（输林格液+万汶液），每组10只大鼠。建立失血性休克大鼠模型后，复苏组在失血性休克1小时后给予不同复苏液（林格液、6%中分子羟乙基淀粉130/0.4即万汶液），复苏2小时后采血，检测血浆组织型纤溶酶原激活剂（tPA）、组织型纤溶酶原激活剂抑制物1（PAI1）、组织因子(TF)的变化。研究结果表明：与对照组、假手术组比较，休克组和复苏1组的tPA、tPA/PAI1、TF水平均明显升高(P 0.01)；复苏1组tPA、tPA/PAI1水平明显高于休克组（P 0.01）；而复苏2组tPA、tPA/PAI1、TF均明显低于休克组和复苏1组（P 0.01）。结论：大鼠失血性休克可使纤溶功能亢进，血小板和凝血系统被活化；采用万汶液加林格液复苏在调节凝血功能方面优于单用林格液。 【关键词】 失血性休克； 凝血因子； 输液治疗； 万汶液；林格液 Experimental Therapeutic Study for Activated Coagulation by Hemorrhagic Shock in Rats Abstract The study ed to investigate the changes of blood coagulation factors during hemorrhagic shock in rats and the effects of various of resuscitation fluids on expression of blood coagulation factors in rats orrhagic shock and to clarify its possible mechanism. 50 SD rats ly divided into 5 groups: control, sham operation, shock, resuscitation 1 (infusion orrhagic shock.freelorrhage shock for 1 hour resuscitation ed easured. At the same time， the rats in shock and the sham operation groups a tPA， tPA/PAI， TF in the shock and resuscitation 1 groups operation groups (P 0.01). The levels of plasma tPA， tPA/PAI in resuscitation 1 group a tPA， tPA/PAI and TF in the resuscitation 2 group orrhagic shock may trigger the coagulation cascade reaction, results in hyperfunctioning of fiberinolysis and activation of platelets and coagulation system, and so the coagulation factor is greatly consumed. Unbalance of coagulation system plays an important role in the progress of shock. Efficacy of resuscitation ay be better than Ringers lactate alone in regulating blood coagulation after hemorrhagic shock in rats. Key orrhagic shock; blood coagulation factor; transfusion therapy; 6% VOLUVEN; Ringers lactate J Exp Hematol 2007; 15(2):396-398 休克的发生发展机制未彻底阐明，其病理生理学过程非常复杂。现在对休克与弥散性血管内凝血（DIC）的关系研究得比较明确，在休克发展到晚期均有可能发生DIC［1］。休克一旦并发了DIC，病情将恶化，微循环和各器官功能将受到严重影响，给治疗造成极大的困难。 创伤后因失血或血浆渗出所致的循环