CAJ | 학술논문

[目的]观察6％羟乙基淀粉130/0．4对脓毒症大鼠凝血四项和血小板的影响。[方法]利用盲肠结扎穿孔术（CLP）制备脓毒症动物模型。80只SD大鼠随机分为4组：正常组（ n ＝8）、假手术组（Sham组，行假手术后3 h用生理盐水作为输注液体，n ＝24）、模型组（SEP组，造脓毒症模型后3 h用生理盐水作为复苏液体，n＝24）和羟乙基淀粉组（HES组，造脓毒症模型后3 h用6％羟乙基淀粉130/0．4作为复苏液体，n＝24）。后三组按采样时间再分为手术后6 h、12 h、24 h三个亚组，每组8只。各组于相应3个时间点经心脏采血，测定大鼠的凝血酶原时间（PT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）和血小板计数（PLT ）的变化。[结果]与正常组相比，Sham组凝血四项指标和PLT手术前后相比较无明显变化（ P ＞0．05）。与Sham组相比，SEP组、HES组在各时间点PT、TT、APTT 明显延长（ P均＜0．05），FIB、PLT 明显减少（ P均＜0．05），但12 h、24 h HES组PT、TT、APTT 升高程度及FIB、PLT 降低程度较SEP组小，且差异有显著性（ P均＜0．05）。[结论]早期应用羟乙基淀粉130/0．4可有效改善脓毒症的凝血功能障碍，一定程度上可缓解脓毒症的进一步发展。
[목적]관찰6％간을기정분130/0．4대농독증대서응혈사항화혈소판적영향。[방법]이용맹장결찰천공술（CLP）제비농독증동물모형。80지SD대서수궤분위4조：정상조（ n ＝8）、가수술조（Sham조，행가수술후3 h용생리염수작위수주액체，n ＝24）、모형조（SEP조，조농독증모형후3 h용생리염수작위복소액체，n＝24）화간을기정분조（HES조，조농독증모형후3 h용6％간을기정분130/0．4작위복소액체，n＝24）。후삼조안채양시간재분위수술후6 h、12 h、24 h삼개아조，매조8지。각조우상응3개시간점경심장채혈，측정대서적응혈매원시간（PT）、응혈매시간（TT）、활화부분응혈활매시간（APTT）、섬유단백원（FIB）화혈소판계수（PLT ）적변화。[결과]여정상조상비，Sham조응혈사항지표화PLT수술전후상비교무명현변화（ P ＞0．05）。여Sham조상비，SEP조、HES조재각시간점PT、TT、APTT 명현연장（ P균＜0．05），FIB、PLT 명현감소（ P균＜0．05），단12 h、24 h HES조PT、TT、APTT 승고정도급FIB、PLT 강저정도교SEP조소，차차이유현저성（ P균＜0．05）。[결론]조기응용간을기정분130/0．4가유효개선농독증적응혈공능장애，일정정도상가완해농독증적진일보발전。
[Objective] To observe the effect of hydroxyethyl starch(HES) 130/0 .4 on 4 coagulation pa-rameters and platelet count(PLT) in sepsis rats .[Methods]Cecum ligation perforatio(CLP) was used to es-tablish animal models with sepsis .A total of 80 healthy SD rats were randomly divided into four groups inclu-ding normal group( n =8) ,sham operation group(sham group ,n =24) ,model group(SEP group ,n =24) and HES group( n =24) .Sham group was injected with normal saline 3h after operation .SEP group was in-jected with normal saline as resuscitation fluid 3h after the establishment of sepsis model .HES group was in-jected with 6% HES 130/0 .4 3h after the establishment of sepsis model .According to sacrifice time ,the later 3 groups were divided into postoperative 6h ,12h and 24h subgroups with 8 rats in each subgroup .Blood sam-ples in each group were drawn from heart at different time .Prothrombin time(PT) ,thrombin time(TT) ,acti-vated partial thrombin time(APTT) ,fibrinogen(FIB) and PLT in rats were examined .[Results]Compared with normal group ,4 coagulation parameters and PLT in sham group had no obvious change before and after operation( P>0 .05) .Compared with sham group ,PT ,TT and APTT in SEP group and HES group at each time point were prolonged obviously (all P < 0 .05) ,but FIB and PLT were decreased obviously (all P <0 .05) ,but the elevation of PT ,TT and APTT and the decreasing of FIB and PLT in HES group at 12 and 24h were less than those in SEP group ,and there were significant differences (all P < 0 .05) .[Conclusion]Early use of HES 130/0 .4 can improve coagulation disorder in sepsis effectively ,and alleviate the further de-velopment of sepsis to some extent .