Departments of Intensive Care Unit, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
Thromb Res. 2011 Dec;128(6):e160-5. doi: 10.1016/j.thromres.2011.07.044. Epub 2011 Aug 17.
In the pathogenesis of sepsis, inflammation and coagulation play a pivotal role. In addition to the anticoagulant activity, unfractionated heparin (UFH) has important immunomodulatory properties. However, different studies have reported conflicting effects on sepsis in association with heparin. The objective of this study is to determine whether UFH is able to reduce endotoxin-induced inflammation and coagulation in mice or produce improved outcome.
C57BL/6J mice were randomly divided into two groups. Experimental mice were given intravenous injection of 8 units/20 g body weight UFH (heparin sodium) diluted in 20 μl sterile saline while the control mice received vehicle sterile saline only. They were injected with LPS (30 mg/kg, i.p.) 0.5h later. Blood was collected and Livers were harvested at 3 and 6h for analysis. In survival studies, a separate group of mice were treated with 8 units/20 g UFH (n=20) or sterile saline (n=20) given intravenously at 1, 12, 24 and 36 hours after LPS injection. Mice were monitored every 12 hours for a maximum of 72 hrs.
These data suggest that UFH attenuates inflammation and coagulation and prevents lethality in endotoxemic mice.
在脓毒症的发病机制中,炎症和凝血起着关键作用。肝素除了具有抗凝活性外,还具有重要的免疫调节作用。然而,不同的研究报告称肝素对脓毒症的影响存在冲突。本研究旨在确定肝素是否能够降低内毒素诱导的小鼠炎症和凝血,或改善预后。
将 C57BL/6J 小鼠随机分为两组。实验组小鼠给予 8 单位/20g 体重肝素钠(肝素钠)稀释于 20μl 无菌生理盐水的静脉注射,而对照组小鼠仅给予无菌生理盐水。0.5 小时后,它们腹腔内注射 LPS(30mg/kg)。在 3 小时和 6 小时时收集血液和肝脏进行分析。在生存研究中,另一组小鼠分别用 8 单位/20g UFH(n=20)或无菌生理盐水(n=20)静脉注射,在 LPS 注射后 1、12、24 和 36 小时。每 12 小时监测一次,最长 72 小时。
1)用肝素预处理小鼠可显著降低血浆中 TNF-α、IL-1β 和 TAT 的水平,在 3 小时和 6 小时时;2)肝素预处理可抑制 3 小时时血细胞中 TNF-α、IL-1β 和组织因子基因的表达;3)肝素预处理可显著减少 LPS 诱导的中性粒细胞扣押(在 3 小时和 6 小时)、血栓形成和肝内纤维蛋白原(在 6 小时)沉积;4)肝素预处理组在 6 小时时 ALT 和 CRE 的水平明显降低;5)肝素治疗可预防内毒素挑战引起的死亡率。
这些数据表明肝素可减轻内毒素血症小鼠的炎症和凝血,并预防其致死性。