骨水泥激活兔血小板促进下肢深静脉血栓形成的实验研究

Effect of PMMA bone cement on formation of deep venous thrombosis by stimulating platelet in rabbits

目的探讨骨水泥是否通过激活兔血小板释放一系列促凝物质入血来促进兔下肢深静脉血栓(DVT)形成。方法聚合后的骨水泥放入兔富含血小板的血浆中,检测血浆中血小板数目和血小板激活分子标记物P-选择素的变化,并对此血浆影响兔体外静脉血凝结、体内静脉血栓形成的时间和大小进行研究。结果骨水泥使兔富含血小板血浆中P-选择素值增高,差异有统计学意义(P<0.05)。此血浆使兔体外静脉血凝结时间缩短,差异有统计学意义(P<0.05),但不影响30min时静脉凝结块的重量,差异无统计学意义(P>0.05)。此血浆使兔体内静脉血栓形成时间缩短,差异无统计学意义(P<0.05),同时在7d时形成的血栓重量重,(P<0.05)。结论骨水泥通过激活兔血小板释放一系列促凝物质入血来促进兔下肢DVT形成。

Objective To explore whether bone cement activate platelet to release some simulative substances of blood clot and whether these substances influence thrombosis. Methods After polymerization of the mixtures, each cement contact with platelet-rich plasma of rabbit. Platelet counting was down. P-selectin was assayed by enzyme immunoassay. Vitro experiment： at the 30 minute clotted time of venous blood, intact thrombi in the tubes were took out, dried and weighed. And vivo experiment： the femoral veins of the experimental group were injected plasma with releasing substance. The vein control group were injected plasma without releasing substance. Then, at the first, fourth and seventh day respectively after operation, intact thrombl in the femoral veins were took out, dried and weighed. Statistical evaluation of the different data was carried out using the paired t-test. Results Bone cement do not lead to decrease of platelet number count and do activate platelet to release some reaction products, including P-selectin. In vitro experiment, rabbit venous blood plasma activated by bone lcement appear to be speed the form of clot, but the weight of clot have been modified. In vivo experiment, rabbit venous blood plasma activated by bone cement appear to be speed the form of clot in the early stage, and the weight of clot had been formed in later stage are bigger. Conclusion Bone cement activate platelet to release some simulative substances of blood clot, for instance P-selectin, and these substances influence thrombosis.