高分子右旋糖酐所致大鼠弥散性血管内凝血的血液动力学变化

Hemodynamic changes in rats with disseminated inravascular coagulation induced by high molecular dextran

目的:应用高分子右旋糖酐复制大鼠弥散性血管内凝血模型,观察高分子右旋糖酐对大鼠血液动力学的影响,并了解其作用是否与注射速度相关。方法:实验于2005-05/07在河北北方学院微循环与危重病研究所完成。取Wistar雄性大鼠30只,随机分为3组(n=10):①1min组:在麻醉状态下颈静脉插管,用130g/L高分子右旋糖酐以15mL/kg剂量经颈静脉注射,1min注完。②3min组:以同样浓度和剂量的高分子右旋糖酐颈静脉注射,3min注完。③对照组:同法注射等量生理盐水。于给药前10min及给药后10,20,30min进行肠系膜微循环观察,计算肠系膜微循环流态积分值(分值越高,血流越慢);30min后,颈动脉放血进行血液流变学及凝血功能测定。观察测定微循环、血黏度、血小板、凝血和纤溶系统的变化。结果:经补充后30只大鼠进入结果分析。①1min组和3min组大鼠肠系膜微循环明显障碍,流态积分值在给药后30min时达到最大值,显著高于对照组(5.66±0.62,5.49±0.75,1.55±0.23,P<0.01)。②1min组和3min组高、中、低各切变率下的全血黏度、血浆黏度、相对黏度均明显高于对照组(P<0.05);但两组间差异无显著性。③1min组和3min组血小板计数和纤维蛋白原水平显著低于对照组(P<0.01),凝血酶原时间长于对照组(P<0.05),但两组间差异无显著性。④1min组和3min组病理检查可见纤维素性血栓和混合血栓,同时血涂片可见大量裂体细胞。结论:高分子右旋糖酐所致大鼠实验性弥散性血管内凝血具有明显的血液动力学异常,该模型应用范围广,效果稳定,其效果与注射速度无关。

AIM： Rat models of disseminated intravascular coagulation （DIC） were established with high molecular dextran to explore its effects on hemodynamic changes in rats and acknowledge whether the mechanism is related with the injection speed. METHODS： The experiment was conducted in the Laboratory of Microcirculation and Critical Care of Hebei North University between May to July 2005. Thirty male Wistar rats were randomly divided into three groups （n =10）. ① One-minute group： rats received intrajugular intubatton under anesthesia, and then were intrajugularly injected with 130 g/L high molecular dextran at 15 mL/kg within one minute. ②Rats in the 3-minute group were given of intrajugular injection of high molecular dextran with the same dose and concentration within 3 minutes. ③Rats in the control group were injected with same volume normal saline. The mesenteric microcirculation was observed respectively at 10 minutes before administration and 10, 20, 30 minutes after administration. The fluid-state score of mesenteric mierocirculation was calculated （the higher the score was, the slowly the blood flow was）. Thirty minutes later, blood was acquired from carotid to measure the hemodynamic changes and coagulation function. The changes of microcirculation, blood viscosity, platelet, coagulation and fibrogenolysis system were observed. RESULTS： After supplementary, 30 rats in all were involved in the analysis of results. ①Mesenteric microcirculation of rats in the 1-minute and 3-minute group represented obvious obstruction, and the fluid-state score reached the peak at 30 minutes after administration, which was significantly higher than that in the control group （5.66±0.62, 5.49±0.75, 1.55±0.23, P 〈 0.01）. ②The whole blood viscosity, plasma viscosity and relative viscosity in 1-minute and 3-minute group under high, intermediate and low frequency were remarkably higher than those in the control group （P 〈 0.05）, while there were no marked differences between the two group. ③The conglutination rate of platelet and level of profibrin in the 1-minute group and 3-minute group were remarkably lower than those in the control group （P 〈 0.01）, and the prothrombin time was longer than that of the control group （P 〈 0.05）, while there were no significant differences between the two group. ④Fibrin thrombus and mixed thrombus could be seen in 1-minute group and 3-minute group through pathological examination, meanwhile, large number of broken cells could be detected on the blood film. CONCLUSION： There is obvious hemodynamic abnormity in rats with DIC induced by high molecular dextran, and the model can be widely applied with stable effect, which is not related with the injection speed.