蛇伤患者凝血、抗凝、纤溶系统的变化及临床意义

The Changes and Significance in Coagulative,Anticoagulant and Fibrinolytic System in Snake-Bite Patients

目的:观察蛇伤患者凝血、抗凝和纤溶系统各项指标的变化并探讨其临床意义。方法:以36例蛇伤患者和32例健康体检者为研究对象,测定血浆凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(Fg)、血管性血友病因子(vWF)、凝血酶调节蛋白(TM)、组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物-1(PAI-1)含量。结果:与正常对照组比较,蛇伤患者PT、APTT、vWF、TM、t-PA、PAI-1水平明显升高,Fg水平明显降低(P<0.01)。结论:蛇伤患者存在凝血、抗凝、纤溶系统的紊乱,早期使用抗蛇毒血清对于防治弥散性血管内凝血(DIC)和多器官功能障碍(MODS)的发生有积极意义。

Objective： To observe the changes in eoagulative, anticoagulant and fibrinolytic system in snake-bite patients and investigate the significance of the changes. Methods：Thirty-six snake-bite patients and 32 normal controls were included in the present study. The levels of prothrombin time （PT）, activated partial thromboplastin time （APTT）, fibrinogen （Fg）, yon Will brand factor （vWF）, thrombomodulin （TM）, tissue plasminogen activator （t-PA）, the plasminogen activator inhibitor-1 （PAI-1） were tested. Results.. The levels of PT, APTT, vWF, TM, t-PA and PAI-1 in snake-bite patients increased. The level of Fg decreased （P〈0. 01）. Conclusion： There is functional disorders in coagulative, anticoagulant and fibrinolytic system in snake-bite patients. Applying antivenomous serum in early stage is eutherapeutic to prevent disseminated intravascular coagulation （DIC） and multiple organ dysfunction syndromes （MODS）.