海水浸泡对腹部开放伤大鼠凝血系统影响的研究

Effects of sea water immersion on blood coagulation in rats with open abdominal injury

目的:观察海水浸泡对腹部开放伤大鼠凝血系统的影响。方法:Wistar大鼠随机分为腹部开放伤合并海水浸泡组和单纯腹部开放伤组,分别检测实验动物致伤后0、0.5、1、2、3、4 h的血浆凝血酶原时间和部分凝血活酶时间,以及血浆纤维蛋白原、纤溶酶原和D-二聚体含量。结果:与单纯腹部开放伤大鼠相比,腹部开放伤合并海水浸泡大鼠血浆凝血酶原时间延长、血浆部分凝血活酶时间缩短、纤维蛋白原含量减少,提示外源性凝血途径被抑制而内源性凝血途径被激活。在海水浸泡2 h后,血浆纤溶酶原和D-二聚体含量增加,提示伴随继发性纤溶亢进。凝血酶原时间和血浆纤溶酶原含量与海水浸泡时间呈正相关(相关系数分别为0.9361和0.9875),血浆纤维蛋白原含量与海水浸泡时间呈负相关(相关系数为0.9136)。结论:海水浸泡可以激活腹部开放伤大鼠凝血系统。在海水浸泡晚期,致伤大鼠具有弥漫性血管内凝血倾向。

Objective： To study the effects on blood coagulation in rats with open abdominal injury at different periods of sea water immersion.Methods：Wistar rats were divided randomly into two groups,the rats in one group treated with open abdominal injury and then immersed in sea water,and the rats in the other group treated with open abdominal injury alone.Prothrombin time,activated partial thromboplastin time,fibrinogen,plasminogen and D-dimer in blood of the rats were examined at 0,0.5,1,2,3 or 4 hours after operation with/without sea water immersion.Results：Comparing to the rats with open abdominal injury alone,coagulation-related parameters in the rats with open abdominal injury and sea water immersion changed distinguishedly.Prothrombin time was prolonged,activated partial thromboplastin time was shortened,and plasma fibrinogen level was decreased,implying the extrinsic coagulation pathway was inhibited,and intrinsic coagulation pathway was initiated.Levels of plasminogen and D-dimer in plasma of the rats with open abdominal injury were elevated after two hours of sea water immersion,predicting fibrinolytic system was activated then.Prothrombin time and levels of plasminogen were positive related to time of sea water immersion（the correlation coefficient was 0.9361 and 0.9875 respectively）.Level of plasma fibrinogen was negative related to time of sea water immersion（the correlation coefficient was 0.9136）.Conclusion：Sea water immersion activates blood coagulation of rats with open abdominal injury.In the late period of immersion,the injury rats are of the trend to suffering with disseminated intravascular coagulation.