重组葡激酶-水蛭素融合蛋白在体外循环抗凝溶栓中的应用比较

Applying Comparative of Anticoagulant and Thrombolytic Sak-Hirudin Fusion Protein Used in Cardiopulmonary Bypass

目的：探讨与比较抗凝溶栓重组葡激酶-水蛭素融合蛋白在体外循环中的应用优势。方法2013年2月～2014年7月，选择镍钛合金片分成未包被组（A 组）、基础包被组（壳聚糖，B 组）、壳聚糖／葡激酶（C 组），壳聚糖／水蛭素（D 组）、壳聚糖／重组葡激酶-水蛭素融合蛋白（E 组），纳入新鲜全人血中进行溶血实验，计算溶血率与血细胞状况。同时健康新生儿脐静脉内皮细胞植入各组别的镍钛合金片，进行细胞相容性实验。结果5组样品溶血率在1.5％左右，5组的红细胞、白细胞和血小板数量均在正常范围内，各组比较差异均无统计学意义（P ＜0.05）。E 组的增殖程度与黏附程度都明显低于其他4组，对比差异明显（P ＜0.05）；A 组与 B 组的相关比较差异无统计学意义（P ＞0.05）。随机双盲法细胞计数结果示 C，D 与 E 组与 A，B 组比较差异有统计学显著性意义（P ＜0.05），同时 E 组与 C，D 组对比差异也有统计学意义（P ＜0.05）。结论相对于葡激酶与水蛭素的单独应用，重组葡激酶-水蛭素融合蛋白在体外循环中的应用能发挥更强的抗凝、抗血栓作用，安全性好，从而确保心血管疾病介入治疗的有效性。

Objective To investigate the applying comparative values of anticoagulant and thrombolytic Sak-hirudin fusion protein used in cardiopulmonary bypass.Methods From february 2013 to July 2014,selected nitinol sheet into uncoated group （group A）,base coated group （chitosan,group B）,chitosan/ Sak group （group C）,chitosan/hirudin group （group D）,chitosan/Sak-hirudin fusion protein group （group E）,there were included in the fresh round of blood hemolysis,the blood cell hemolysis rates were calculated.Meanwhile used the healthy newborns umbilical vein endothelial cells were added into various categories nitinol sheet for cell compatibility testing.Results The samples hemolysis rates in the 5 groups were around 1.5% and the RBC,WBC and PLT counts compared in the 5 groups were showed no differences （P 〈0.05）.The extent of proliferation and adhesion in the group E were significantly lower than the other four groups,compared to significant differences （P 〈0.05）.There were no differences to compare group A and group B （P 〉0.05）.Randomized doubleblind cell count result shows that the group C,D and E compared to the group A,B were more significant differences （P 〈0.05）, at the same time,the group E compared to the group C,D differences were statistically significant （P 〈0.05）.Conclusion Compared to Staphylokinase and hirudin alone,Sak-hirudin fusion protein used in cardiopulmonary bypass can play stronger anticoagulant and antithrombotic effects,its safety and ensures the effectiveness that interventional treatment of cardiovascular disease.