Li D, Ruan S, Hu A
Burn Center, 251st Hospital of People's Liberation Army, Zhangjiakou.
Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1998 Jan;14(1):45-8.
To investigate the mechanism of hemorrhagic tendency after phosphorus poisoning.
45% phosphoric acid and 20 mg/cm2 phosphorus were used to produce burn injury in rabbits. The total content of phosphorus remaining on the wound and 7-day mortality were similar in both groups.
The results showed that plasma free calcium contents were significantly lower in both phosphorus groups than healthy and thermal burn controls (0.80 vs 1.40 mol/l, P < 0.01). The free calcium content of platelet was lowered to 116-140 nmol/l, which was significantly lower than that of healthy control (285 nmol/l) and thermal injury group (480-504 nmol/l). Concomitantly, the platelet aggregation rate was lowered to 1.29% and 10.78% in phosphoric acid group and phosphorus group, respectively, while it was 67.01% in healthy control and 82.1%-84.9% in thermal injury group; the difference was statistically significant.
Calcium therapy brought back intracellular and extracellular free calcium contents to normal in phosphorus burn group. Also platelet aggregation rate approached normal level after calcium therapy. The results suggest that the bleeding tendency after phosphorus burn is due to combination of phosphorus with intracellular and extracellular calcium of platelets, thus inhibiting aggregation of platelets.
探讨磷中毒后出血倾向的机制。
用45%磷酸和20mg/cm²磷对家兔造成烧伤。两组伤口残留磷的总量和7天死亡率相似。
结果显示，磷中毒两组的血浆游离钙含量均显著低于健康对照组和热烧伤对照组（0.80 vs 1.40mol/l，P<0.01）。血小板游离钙含量降至116 - 140nmol/l，显著低于健康对照组（285nmol/l）和热损伤组（480 - 504nmol/l）。同时，磷酸组和磷中毒组的血小板聚集率分别降至1.29%和10.78%，而健康对照组为67.01%，热损伤组为82.1% - 84.9%；差异有统计学意义。
钙剂治疗使磷烧伤组细胞内和细胞外游离钙含量恢复正常。钙剂治疗后血小板聚集率也接近正常水平。结果表明，磷烧伤后的出血倾向是由于磷与血小板细胞内和细胞外钙结合，从而抑制了血小板的聚集。
