ESWL对机体凝血及纤溶系统的影响和钙拮抗剂的防护性作用

Protective effect of Ca￣(++) entry blocker to ESWL effect on coagulation and fibrinolysis

为了解ＥＳＷＬ后肾脏血管受损、机体血液状态改变情况及钙拮抗剂对其作用的影响，将３０只家兔随机分为两组，Ａ组未用异搏定，Ｂ组异搏定处理，观察ＥＳＷＬ前后血浆凝血纤溶参数的变化。Ａ组抗凝血酶Ⅲ（ＡＴ－Ⅲ）和纤溶酶原激活抑制物（ＰＡＩ）在ＥＳＷＬ后１～３天明显下降，纤维蛋白原降解产物（ＦＤＰ）和纤维蛋白原明显升高；Ｂ组仅纤维蛋白原和ＦＤＰ在ＥＳＷＬ后１、３天升高。提示ＥＳＷＬ后早期机体存在血液高凝、纤溶亢进状态，可能与肾损害有关，异搏定可纠正凝血和纤溶的平衡失调，改善血液状态。

rabbits were randomly divided into two groups:group A(n=15 ) with no verapamil and group B(n=15) with verapamil. In group A, a significant decrease of AT-Ⅲ and PAI was noted 1～3 days after ESWL and a marked increase of FDP and fibrinogen 1 and 3 days after ESWL respectively. While in group B, there was only a significant increase of FDP and fibrinogen with no change of AT-Ⅲ and PAI. Hypercoagulative and hyperfibrinolytic states might occur in the early stage after ESWL and would result in renal injury.Verapamil would correct the disturbance in coagulation and fibrinlysis, thus lessening the renal damage.