蕲蛇酶联合肝素治疗兔急性下腔静脉血栓的实验研究

An experimental study of acutobin and heparin on acute inferior vena cava thrombus in rabbits

目的 探讨蕲蛇酶联合肝素治疗兔急性下腔静脉血栓的有效性及安全性.方法 新西兰大白兔72只建立急性下腔静脉血栓模型后随机分为肝素组（A组）、尿激酶联合肝素组（B组）、蕲蛇酶联合肝素组（C组）,每组24只.各组在血栓形成3 d后给药,分别在用药后的3、7、10 d检测各组凝血指标评估其安全性,通过静脉彩超评估其有效性.结果 C组的凝血酶原时间（prothrombin time,PT）延长时间较B组短（P〈0.05）,纤维蛋白原（fibrinogen,FBG）值较B组小（P〈0.05）,B组和C组PT延长时间较A组长（P〈0.01）,FBG值较A组大（P〈0.01）,B组和C组的D-二聚体值（D-dimer,D-D）均逐渐降至正常,差异无统计学意义（P〉0.05）.B组和C组的溶栓效果均较A组效果好,B组与A组差异有统计学意义（P〈0.01）,第10天时,C组与A组差异有统计学意义（P〈0.01）.B组和C组溶栓效果差异无统计学意义（P〉0.05）.结论 蕲蛇酶联合肝素治疗兔急性下腔静脉血栓是有效的,并且具有较高的安伞性.

Objective To investigate the effectiveness and safety of combined heparin and acutobin in the treatment of acute inferior vena cava thrombus in rabbits. Methods The inferior vena cava thrombus model was established in 72 rabbits and they were randomly divided into three groups heparin group（A） , group for combination of urokinase and heparin （B）, group for combination of acutobin and heparin （C） ,each group including 24 rabbits. Drugs were administrated 3 days after thrombosis. Coagulation indexes were tested to assess their safety, and Doppler ultrasound was used to assess their effectiveness, on day 3, day 7, and day 10. Results The prolongation of prothrombin time （ PT） in group C was shorter than that in group B（ P 〈 0. 05 ） , the fibrinogen （ FBG） value in group C was lower than that in group B （P 〈 0. 05 ） , the prolongation of PT in group B and group C was longer than that in group A （P 〈 0. 01）, the FBG value of group B and C were higher than that in group A （ P 〈 0. 01 ）, D-dimer （ D-D） value in group B and C gradually returned to normal range. There was no difference between the two groups （P 〉 0. 05）. The thrombolytic effect in group B and C were better than that in group A, statistical difference was reached between groups B and A （P 〈0. 01）, and the difference was statistically significant between groups C and A 10 days after administration （P 〈 0. 01）. Thrombolytic effect was not different statistically between groups B and C （P 〉 0. 05）. Conclusion Acutobin combined with heparin in the treatment of acute inferior vena cava thrombus in rabbits was effective and safe.