Naughton B A, Moore E, Bush M E, Lapin D M, Dornfest B S
Medical Laboratory Sciences Department, Hunter College School of Health Sciences, New York, NY 10010.
J Med. 1989;20(5-6):305-30.
Phenylhydrazine (PHZ) is a hemolytic agent which has been used in the treatment of polycythemia vera. Recent studies performed in our laboratory have indicated that the PHZ-induced anemia is immuno-hemolytic in etiology, and a prolonged bleeding time was present in some of the rats chronically treated with PHZ. The nature of this bleeding tendency was explored in the present experiment. PHZ was administered to rats once a week for a six week period. During this time, the animals were monitored for prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen concentration, and individual coagulation factor levels as well as routine plasma chemistries and blood cell counts. In addition, radioimmunoassays (RIA) for prostacyclin, a platelet aggregation inhibitor, and prostaglandin (PG) E2 were performed. PHZ-treated animals displayed a significant elevation in both PT and APTT when compared with saline injected controls, although plasma fibrinogen levels were not appreciably altered. Further tests revealed a PHZ-induced decrease in prothrombin and factor V levels. In addition, a significant increase in plasma serum glutamate oxaloacetate transaminase (SGOT), lactate dehydrogenase (LDH), and alkaline phosphatase levels was observed as well as a diminution in cholesterol and triglycerides following PHZ administration. PHZ treatment also induced an elevation in prostacyclin levels and transient thrombocytopenia. These findings indicate that several factors may contribute to the prolonged bleeding time in PHZ-treated rats including a drug induced thrombocytopenia possibly associated with enhanced synthesis of autologous immunoglobulin G (IgG) against the senescent red cell antigen, and diminished synthesis of vitamin K-dependent coagulation factors which may be mediated by reduced vitamin K uptake by the hypo-cholesterolemic subjects.
苯肼(PHZ)是一种溶血剂,曾用于治疗真性红细胞增多症。我们实验室最近进行的研究表明,PHZ诱导的贫血在病因上是免疫性溶血,并且一些长期接受PHZ治疗的大鼠存在出血时间延长的情况。本实验探讨了这种出血倾向的本质。每周给大鼠注射一次PHZ,持续六周。在此期间,监测动物的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原浓度、各个凝血因子水平以及常规血浆化学成分和血细胞计数。此外,还进行了血小板聚集抑制剂前列环素和前列腺素(PG)E2的放射免疫分析(RIA)。与注射生理盐水的对照组相比,接受PHZ治疗的动物的PT和APTT均显著升高,尽管血浆纤维蛋白原水平没有明显改变。进一步检测发现,PHZ导致凝血酶原和因子V水平降低。此外,观察到PHZ给药后血浆血清谷氨酸草酰乙酸转氨酶(SGOT)、乳酸脱氢酶(LDH)和碱性磷酸酶水平显著升高,同时胆固醇和甘油三酯减少。PHZ治疗还导致前列环素水平升高和短暂性血小板减少。这些发现表明,几个因素可能导致PHZ治疗的大鼠出血时间延长,包括药物诱导的血小板减少,这可能与针对衰老红细胞抗原的自身免疫球蛋白G(IgG)合成增强有关,以及维生素K依赖性凝血因子合成减少,这可能是由低胆固醇受试者维生素K摄取减少介导的。