鸡矢藤对肋骨骨折患者体内花生四烯酸代谢产物的影响

Effect of Paederia Scandens on Metabolites of Arachidonic Acid in Patients with Rib Fracture

目的:探讨鸡矢藤对肋骨骨折患者体内花生四烯酸代谢产物的影响。方法:利用放射免疫分析法,测定鸡矢藤组和对照组各30例的胸外伤肋骨骨折患者伤后第1、4、7天的血清白三烯E4(LTE4)、血栓素B_2(TXB2)、6-酮-前列腺素F1α(6-Keto-PGF1α)水平,检测血小板计数(BPC)和部分凝血酶原时间(APTT)的改变。结果:2组第1、4、7天Price-Henry疼痛评分比较,差异有统计学意义(P<0.05)。2组肺不张以及肺部感染发生率比较,差异有统计学意义(P<0.05)。鸡矢藤组APTT与对照组在第1和第4天比较,差异有统计学意义(P<0.05);2组BPC在第1、4、7天比较,差异有统计学意义(P<0.05),但鸡矢藤组BPC在第7天上升更快(P<0.05)。第4天2组LTE4均有增高,与对照组比较,差异有统计学意义(P<0.05)。第4天2组血浆TXB2浓度均增加,但鸡矢藤组增加幅度低于对照组(P<0.05),第7天后TXB2浓度已降到第1天水平。第4天鸡矢藤组血浆6-Keto-PGF1α浓度较对照组有升高(P<0.05),第7天2组已低于第1天水平,但鸡矢藤组明显高于对照组(P<0.05)。结论:鸡矢藤在肋骨骨折时镇痛消炎的作用机理与减少花生四烯酸代谢产物有关,对患者的凝血功能无影响,镇痛消炎效果好,减少肺部并发症的发生。

Objective：To observe the effect of paederia scandens on metabolites of arachidonic acid in patients with rib fracture.Methods：Tested levels of serum leukotriene E4（LTE4）,thromboxane B2（TXB2）,6-keto-prostaglandin F1α（6- Keto- PGF1α） for 30 patients with rib fracture of thoracic trauma of the paederia scandens group or the control group after the first,fourth and seventh day of injury with radioimmunoassay,and detected change of blood platelet count（BPC） and activated partial thromboplastin time（APTT）.Results：Compared Price- Henry pain score of the first,fourth and seventh day of the two groups,the differences were significant（P〈0.05）.Compared incidence of pulmonary atelectasis and pulmonary infection of the two groups,the differences were significant（P〈0.05）.Compared APTT of the two groups in the first and the fourth day,the differences were significant（P〈0.05）.Compared BPC of the two groups in the first,fourth and seventh day,the differences were significant（P〈0.05）,but the increase of BPC of the paederia scandens group was more effective（P〈0.05）.In the fourth day,LTE4 of the two groups were both increased,and there being significant difference in the comparison between two groups（P〈0.05）.In the fourth day,concentrations of TXB2 in plasma of the two groups were both increased,but increasing extent of the paederia scandens group was lower than that of the control group（P〈0.05）.After the seventh day,TXB2 concentrations of the paederia scandens group were the same as those of the first day.In the fourth day,comparing with the control group,concentrations of 6- Keto- PGFlα in plasma of the paederia scandens group were increased（P〈0.05）.In the seventh day,the concentrations of the two groups were both lower than those in the first day,but concentrations of the paederia scandens group were higher than those of the control group significantly（P〈0.05）.Conclusion：Mechanism of Paederia scandens on analgesic and anti- inflammatory for rib fracture is related to reduction of metabolites of arachidonic acid,which has no effect on the coagulation function of patients,and has good analgesic and anti- inflammatory effect,can reduce the occurrence of pulmonary complications.