微循环衰竭患者纤维蛋白单体聚合反应速率的研究

Significance in Variatons of Fibrin Monomer Polymerization Velocity in Patients with Microcirculation Failure

目的 :探讨微循环衰竭 (MCF)患者纤维蛋白单体聚合速率 (FM PV)的改变及其临床意义。方法 :采用蕲蛇毒诱导血浆纤维蛋白单体形成 ,于分光光度计上观察纤维蛋白原转变成纤维蛋白的时间过程并用微机分析图形。结果 :42例弥散性血管内凝血 (DIC)和其中13例伴发休克患者的FMPV检测结果显示 :DIC患者 ,特别是伴有休克患者的FMPV较正常对照组有明显的被抑制现象 ,同时DIC伴有休克者FMPV较DIC未伴休克组相对增强 ,凝血过度激活状况明显 ,治疗效果较差 ,死亡率高。结论 :MCF患者FMPV有明显的异常改变 ,其预后较差 ,FMPV检测对MCF病程进展、预后评价可能有一定临床价值。

Objective: To explore the variation in the plasma fibrinogen function of the patient with microcirculation failure(MCF) and discuss its clinical relevance.Method: Agkistrodon acutus venom was used to induce the plasma fibrin polymerization and the time course of fibrin polymerization was monitered by a spectrophotometer at 340 nm.The change in velocity of fibrin polymerization was analyzed by PC.Results: Forty two patients with disseminated intravascular coagulation(DIC) including 13 patients with the complication of shock were involved in the study.It showed that the fibrin monomer polymerization velocity(FMPV) of patients with DIC (especially those complicated with shock) was significantly surpressed as compared with normal control.It was more pronounced in surpression of FMPV than those patients simply with DIC.Also the more active coagulation in vivo in these patients was indicated.The therapeutic effects to patients of DIC with shock were worse,and the mortality rate was higher too.Conclusion: There is significant variation in FMPV in patients with MCF.FMPV may have certain clinical value in evaluation in progression and prognosis of the patients with MCF.