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复方丹参溶液对大鼠失血性休克合并凝血功能障碍的治疗作用

[Therapeutic effect of compound danshen solution on hemorrhagic shock combined with coagulopathy in rats].

作者信息

Pan Jing-Ye, Zhang Yan-Jie, Wang Ming-Shan, Jing Ke-Ke

机构信息

ICU, The First Affiliated Hospital, Wenzhou Medical College, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2005 Jun;13(3):456-9.

Abstract

To investigate the effects of complex danshen solution and heparin on the changes of blood coagulation factors in rats with hemorrhagic shock, and to explore the therapy of coagulopathy by compound danshen solution, the rat model of hemorrhagic shock was set up, 40 SD rats were randomized into four groups: sham operation, shock, compound danshen solution and heparin groups, each group was composed of 10 SD rats. Plasma SFMC, TM, ATIII, D-D, t-PA, PAI levels and APTT were detected, incidences of bleeding complications between heparin and danshen group were compared. The results showed that plasma SFMC, D-D levels in shock group were higher but ATIII level in shock group was lower than that in sham operation group, compound danshen solution group and heparin group (P < 0.001), TM levels obviously increased in shock group and heparin group (P < 0.001). There was no significant difference between compound danshen solution and sham-operation groups. Plasma t-PA, D-D levels obviously increased after shock for 2 hours, PAI level reached the peak after shock for 4 hours, but t-PA decreased. After shock for 6 hours, plasma PAI descended, t-PA continually drop in, but PAI and D-D remained in higher levels. Plasma D-D level in heparin group was lower than that in shock group, t-PA level was higher than that in shock group, but there was no significant difference between in heparin and shock groups. Plasma t-PA, PAI and D-D levels in compound danshen solution group were lower than that in shock group. APTT of danshen group was lower than that of shock group and heparin group. Bleeding incidences was 30% in heparin group and 0% in danshen group, respectively. It is concluded that compound danshen solution may used to treat hypercoagulation and hyperfibrinolysis. In comparsion with heparin, danshen posses-ses advantages of safety with less bleeding complication and needs not tight monitor.

摘要

为探讨复方丹参溶液和肝素对失血性休克大鼠凝血因子变化的影响,探索复方丹参溶液对凝血病的治疗作用,建立大鼠失血性休克模型,将40只SD大鼠随机分为四组:假手术组、休克组、复方丹参溶液组和肝素组,每组10只SD大鼠。检测血浆可溶性纤维蛋白单体复合物(SFMC)、血栓调节蛋白(TM)、抗凝血酶Ⅲ(ATⅢ)、D-二聚体(D-D)、组织型纤溶酶原激活剂(t-PA)、纤溶酶原激活物抑制剂(PAI)水平及活化部分凝血活酶时间(APTT),比较肝素组与丹参组出血并发症发生率。结果显示,休克组血浆SFMC、D-D水平高于假手术组、复方丹参溶液组和肝素组,而休克组ATⅢ水平低于假手术组、复方丹参溶液组和肝素组(P<0.001),休克组和肝素组TM水平明显升高(P<0.001)。复方丹参溶液组与假手术组无显著差异。休克2小时后血浆t-PA、D-D水平明显升高,休克4小时后PAI水平达峰值,但t-PA下降。休克6小时后,血浆PAI下降,t-PA持续下降,但PAI和D-D仍处于较高水平。肝素组血浆D-D水平低于休克组,t-PA水平高于休克组,但肝素组与休克组无显著差异。复方丹参溶液组血浆t-PA、PAI和D-D水平低于休克组。丹参组APTT低于休克组和肝素组。肝素组出血发生率为30%,丹参组为0%。结论:复方丹参溶液可用于治疗高凝和高纤溶状态。与肝素相比,丹参具有安全性好、出血并发症少且无需严密监测的优点。

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