创伤性失血性休克大鼠血浆血栓调节蛋白的动态测定及价值

Dynamic Observation and Value of Plasma Level of Thrombomodulin in Rats with Traumatic Hemorrhagic Shock

目的：探讨创伤性失血性休克（traumatic hemorrhagic shock，THS）中血浆血栓调节蛋白（thrombomodulin，TM）动态变化及其临床价值。方法选择无特定病原体成年大鼠17只，通过急性失血方式建立收缩压下降曲线，形成THS动物模型，测定收缩压基础值（T1），记录收缩压降至基础值3／4（T2）、基础值1／2（T3）、基础值2／5（T4）、基础值1／5（T5），10 mmHg（T6）失血量，采用酶联免疫吸附分析检测各个时间点血浆TM水平。结果各时间组间存在显著性差异，T2-T3时间段内TM水平随时间延长而升高，T4-T5时间段内TM水平随时间延长而降低，T5-T6时间段内 TM水平随时间延长而升高。结论选择收缩压下降曲线建立THS模型评估失血量变化，结合 TM水平动态监测，可对血管内皮细胞损伤程度与THS相关过程进行有效评估。

Objective To explore the dynamic changes in the plasma levels of thrombomodulin（TM）with traumatic hemorrhagic shock （THS）.Methods The model of the THS with gradient decerease in the systolic blood pressure was eatablished in 17 rats without specific pathogen.The arterial blood during the different phase of shock,i.e.when the systolic pressures were three forth,one second,two fifth of the basis systolic blood pressure,one fifth of the basic systolic blood pressure and 10mmHg,was collected and TM levels in the plasma were determined by the double antibody sandwich method of enzymelabeled immunosorbent assay （ELISA）and analyzed.Results There were significant differences in plasma levels of TM between groups,with TM levels in T2-T3 period of time increased with the extension of time,and TM levels in T4-T5 period of time decreased with the extension of time,and TM levels in T5-T6 period of time increased with the extension of time.Conclusion The animal model of THS was related to the systolic pressure during the shock,may be helpful to assessment changes in blood loss.The dynamic observation of the plasma levels of TM which is a good index of the damage to the vascular endothelial cells,may be helpful to assessment of the THS is related to the degree of damage to the vascular endothelial cells.