乌司他丁对幼猪胰-肾联合移植术凝血功能的影响

Effect of ulinastatin on coagulation during simultaneous pancreas-kidney transplantation in piglets

目的评估乌司他丁对幼猪胰-肾联合移植术凝血功能的影响。方法复制胰-肾联合移植模型,随机将配成12对的幼猪均分为乌司他丁组(Ⅰ组)和对照组(Ⅱ组),分别持续静脉泵注乌司他丁15kU·kg-1·h-1或等量生理盐水直至术后。分别于术前(T0)、受体动静脉吻合完毕开放时(T1)、开放后1h(T2)、2h(T3)、术毕(T4)各时点采外周动脉血测定凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、抗凝血酶Ⅲ(AT-Ⅲ)、纤维蛋白原(Fig)及D-二聚体(D-D)浓度。结果两组PT、APTT差异无统计学意义。两组T2、T3、T4时AT-Ⅲ明显高于T0时(P<0.05),Ⅰ组T3、T4时AT-Ⅲ明显高于Ⅱ组(P<0.05)。Ⅱ组T3、T4时Fig明显低于T0时,Ⅱ组T2时D-D明显高于T0时及Ⅰ组(P<0.05)。结论乌司他丁能有效减轻幼猪胰肾联合移植术的凝血紊乱。

Objective To evaluate the effects of ulinastatin（UTI）on coagulation during piglet simultaneous pancreas-kidney transplantation. Methods Using simultaneous pancreas-kidney transplantation model of piglets, twelve couples of piglets were randomly divided into two groups. Piglets in UTI group （n=6） were injected with constant pumped infusion of UTI 15 kU · kg^-1 · h^-1 until postoperative period. Those in control group （n=6） were treated with constant pumped infusion of 0.9% saline. The blood samples were collected to measure the coagulation variables of prothrombin time（PT）, activated partial thromboplastin time（APTT）, antithrombin Ⅲ （AT-Ⅲ）, fibrinogen （Fig） and D-dimer （D-D） before operation（T0 ） ,at the end of arterio-venous anastomosis （T1） ,at I h and 2 h after patency （T2 and T3 ） ,at the end of operation（T4 ）. Results PT and APTT of two groups were similar. Compared with control group, AT-Ⅲ and Fig were higher and D-D was lower in UTI group. Conclusion It is suggested that ulinastatin could reduce coagulpathy induced by simultaneous pancreas-kidney transplantation in piglets.