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[不同剂量氢化可的松对脓毒性休克早期大鼠凝血紊乱的影响]

[Effects of different doses of hydrocortisone on the disorder of coagulation in rats at early stage of septic shock].

作者信息

Wang Quan, Qian Su-yun, Yang Xin-li, Jin Jian-yun, Li Yu-qing

机构信息

Emergency Center, Beijing Children's Hospital, Capital University of Medical Sciences, Beijing 100045, China.

出版信息

Zhonghua Er Ke Za Zhi. 2006 Jan;44(1):49-52.

Abstract

OBJECTIVE

To investigate the effects of different doses of hydrocortisone (HC) on the disorder of coagulation in rats at early stage of septic shock.

METHODS

The model of early septic shock accompanied by the disorder of coagulation in rats was set up by bolus injection of lipopolysaccharide (LPS) at 25 mg/kg through right femoral vein. Forty male Wistar rats were randomly divided into the following 5 groups: normal control (LPS and HC were substituted by same volume of normal saline solution), shock group (HC was substituted by same volume of normal saline), high-dose HC (HD group, HC 100 mg/kg), medium-dose HC (MD group, HC 50 mg/kg) and low-dose HC (LD group, HC 5 mg/kg). Four hours after the HC treatment, the blood specimens were collected for the count of blood platelet (PLT), the activity of antithrombin III (ATIII), the content of D-dimer and von Willebrand factor (vWF).

RESULTS

The count of PLT (x 10(9)/L) and the activities of ATIII (%) in shock group (586.00 +/- 71.179 and 50.600 +/- 19.248) were significantly lower than that in normal control group (1012.600 +/- 20.852 and 89.200 +/- 12.109), and the level of D-dimer (microg/dl) and vWF (%) in LPS group (1.680 +/- 0.999 and 7.288 +/- 0.652) as significantly higher than that in normal control group (0.66 +/- 0.772 and 3.656 +/- 1.407), P < 0.05. After HC treatment, the disorder of coagulation was attenuated to different degree. However, significant difference was found between HD, MD groups and shock group only in the count of PLT (P = 0.000), and there were no significant differences between HD, MD groups and shock group in the other three indices. Significant improvements were found in LD group (P < 0.05) in all the four indices and there were no significant differences between LD group and normal group in D-dimer and vWF. The effects of medium-dose HC was between LD and HD groups, and there were no significant differences between HD and MD group, P > 0.05.

CONCLUSIONS

The results indicated that different doses of HC had different effects on coagulation in early stage of septic shock in rats. Low-dose HC may ameliorate the disorder of coagulation in early septic shock in rats. High-dose and medium-dose of HC had no significant improving effects on the disorder of coagulation.

摘要

目的

探讨不同剂量氢化可的松(HC)对脓毒性休克早期大鼠凝血功能紊乱的影响。

方法

通过右股静脉推注25mg/kg脂多糖(LPS)建立伴有凝血功能紊乱的大鼠早期脓毒性休克模型。40只雄性Wistar大鼠随机分为以下5组:正常对照组(用等体积生理盐水替代LPS和HC)、休克组(用等体积生理盐水替代HC)、高剂量HC组(HD组,HC 100mg/kg)、中剂量HC组(MD组,HC 50mg/kg)和低剂量HC组(LD组,HC 5mg/kg)。HC治疗4小时后,采集血液标本检测血小板计数(PLT)、抗凝血酶III活性(ATIII)、D - 二聚体含量及血管性血友病因子(vWF)。

结果

休克组的PLT计数(x 10(9)/L)和ATIII活性(%)(586.00±71.179和50.600±19.248)显著低于正常对照组(1012.600±20.852和89.200±12.109),LPS组的D - 二聚体水平(μg/dl)和vWF(%)(1.680±0.999和7.288±0.652)显著高于正常对照组(0.66±0.772和3.656±1.407),P<0.05。HC治疗后,凝血功能紊乱在不同程度上得到缓解。然而,HD组、MD组与休克组仅在PLT计数上有显著差异(P = 0.000),在其他三项指标上HD组和MD组与休克组无显著差异。LD组在所有四项指标上均有显著改善(P<0.05),且在D - 二聚体和vWF方面LD组与正常组无显著差异。中剂量HC的效果介于LD组和HD组之间,HD组和MD组之间无显著差异,P>0.05。

结论

结果表明不同剂量的HC对大鼠脓毒性休克早期的凝血功能有不同影响。低剂量HC可能改善大鼠早期脓毒性休克的凝血功能紊乱。高剂量和中剂量HC对凝血功能紊乱无显著改善作用。

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