重组水蛭素治疗兔弥散性血管内凝血

Recombinant hirudin in treatment of disseminated intravascular coagulation exper imentally in rabbits

目的:观察重组水蛭素对治疗脂多糖致兔弥散性血管内凝血模型的抗凝疗效。方法:建立兔脂多糖弥散性血管内凝血模型,18只新西兰大白兔随机分为3组,静脉注射脂多糖的同时分别予生理盐水、普通肝素和重组水蛭素,于注射脂多糖前,注射后2,4,6h检测血小板计数、活化部分凝血活酶时间、抗凝血酶Ⅲ、纤维蛋白原、血清纤维蛋白降解产物(FDP);并观察心、肺脏器的病理变化。结果:模型组兔活化部分凝血活酶时间明显延长,血小板计数和纤维蛋白原显著降低,抗凝血酶Ⅲ活性明显下降,与肝素组相比重组水蛭素组血小板和纤维蛋白原消耗减少,抗凝血酶Ⅲ活性下降程度减轻。所有实验动物血清FDP变化无统计学差异。病理检查模型组心、肝、肺、肾、脾脏可见微血栓形成,重组水蛭素组均未见微血栓形成。结论:重组水蛭素具有明显的抗凝作用,可有效治疗弥散性血管内凝血。

AIM: To observe the effect of recombinant hirudin for the treatment of anti-co agulation for disseminated intravascular coagulation in rabbit. METHOD: A mo d el of disseminated intravascular coagulation was established by injecting lipopo lysaccharide in rabbits. Eighteen rabbits were randomly divided into three group s, treating with normal saline, heparin and recombinant hirudin, respectively. A c tivated partial thromboplastin time (APTT), platelet counts, antithrombin Ⅲ, fi brinogen and fibrin degradation products were determined before and 2, 4, 6 h after iv lipopolysaccharide. Histological and patho-physiologic changes wer e observed. RESULTS: APTT in rabbit model of heparin treatment group prolonged remarkably, fibrinogen and platelet counts and antithromb in Ⅲ were obviously decreased with disseminated intravascular coagulation. The changes of fibrinogen , patelet co unts and antithrombin Ⅲ were decreasd in recombinant hirudin therapy group in c omparing with the heparin group. The serum fibrin degradation products showed no obv ious change in all groups of rabbits. Thromboembolisms were found in the model group but not in treatment groups. CONCLUSION:Recombinant hirudin has obvious and effective anticoagulant influenc e in disseminated intravascular coagulation.