大鼠失血性休克继发凝血活化实验治疗.docVIP

大鼠失血性休克继发凝血活化实验治疗 　 作者：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(Plt;0.01)；复苏1组tPA、tPA/PAI1水平明显高于休克组（Plt;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（Plt;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 was aimed 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 with hemorrhagic shock and to clarify its possible mechanism. 50 SD rats were randomly divided into 5 groups: control, sham operation, shock, resuscitation 1 (infusion with Ringer’s lactate) and resuscitation 2 (infusion with 6% VOLUVEN ), 10 rats per group. The rats in resuscitation 1 and resuscitation 2 groups were subjected to hemorrhagic shock， after hemorrhage shock for 1 hour resuscitation was performed with Ringer’s lactate and 6% VOLUVEN. After resuscitation for 2 hours the changes of tPA， PAI1， TF were measured. At the same time， the rats in shock and the sham operation groups were bloodleted out so as to test. The results showed that the levels of plasma tPA， tPA/PAI， TF in the shock and resuscitation 1 groups were significantly higher than that in control and sham operation groups (Plt;0.01). The levels of plasma tPA， tPA/PAI in resuscitation 1 group were higher than that in shock group (Plt;0.01), the levels of plasma tPA， tPA/PAI and TF in the resuscitation 2 group were significantly lower than that in shock and resuscitation 1 groups (Plt;0.01). It is concluded that hemorrhagic shock may trigger the coagulation cascade reaction,