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参附注射液对猪心脏骤停模型凝血-纤溶紊乱的影响。

Effects of Shen-Fu injection on coagulation-fibrinolysis disorders in a porcine model of cardiac arrest.

作者信息

Yin Qin, Liu Bo, Wu Caijun, Yang Jun, Hang Chenchen, Li Chunsheng

机构信息

Emergency Department, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University; Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation (NO. BZ0370), Beijing, China.

出版信息

Am J Emerg Med. 2016 Mar;34(3):469-76. doi: 10.1016/j.ajem.2015.12.010. Epub 2015 Dec 12.

Abstract

OBJECTIVE

The objective of the study is to investigate the effects of Shen-Fu injection (SFI) on coagulation-fibrinolysis disorders in a porcine model of cardiac arrest.

MATERIALS AND METHODS

Thirty Wuzhishan pigs were randomly assigned into the sham operation group (SO group, n = 6), epinephrine group (EP group, n = 12), and SFI group (n = 12). After 8 minutes of untreated ventricular fibrillation (VF), pigs in the EP group or SFI group were administered with either EP (0.02 mg/kg) or SFI (1.0 mL/kg), respectively. Plasma levels of tissue factor, thrombin-antithrombin complex, tissue factor pathway inhibitor, antithrombin III, protein C, tissue plasminogen activator, plasminogen activator inhibitor 1, soluble thrombomodulin, and soluble endothelial protein C receptor were measured at baseline, 1, 6, 12, and 24 hours after return of spontaneous circulation (ROSC). In addition, arterial lactate levels were measured at baseline, 1, 6, 12, and 24 hours after ROSC, and lactate clearance was calculated at 1, 6, 12, and 24 hours after ROSC.

RESULTS

Compared with the EP group, tissue factor, thrombin-antithrombin complex, tissue factor pathway inhibitor, tissue plasminogen activator, and plasminogen activator inhibitor 1 levels were significantly lower, whereas antithrombin III and protein C levels were significantly higher in the SFI group (all P < .05). In addition, soluble thrombomodulin and soluble endothelial protein C receptor levels in the SFI group were significantly lower in comparison to the EP group (all P < .01). Furthermore, arterial lactate levels were significantly lower, and lactate clearance was higher in the SFI group (all P < .01).

CONCLUSIONS

This study demonstrates that SFI can inhibit coagulation-fibrinolysis disorders after cardiac arrest, which may be associated with alleviating endothelial damage and improving systemic metabolism.

摘要

目的

本研究旨在探讨参附注射液(SFI)对猪心脏骤停模型中凝血-纤溶紊乱的影响。

材料与方法

30只五指山猪被随机分为假手术组(SO组,n = 6)、肾上腺素组(EP组,n = 12)和SFI组(n = 12)。在未经处理的室颤8分钟后,EP组或SFI组的猪分别给予肾上腺素(0.02 mg/kg)或SFI(1.0 mL/kg)。在自主循环恢复(ROSC)后的基线、1、6、12和24小时测量血浆组织因子、凝血酶-抗凝血酶复合物、组织因子途径抑制剂、抗凝血酶III、蛋白C、组织型纤溶酶原激活剂、纤溶酶原激活剂抑制剂1、可溶性血栓调节蛋白和可溶性内皮蛋白C受体水平。此外,在ROSC后的基线、1、6、12和24小时测量动脉乳酸水平,并在ROSC后的1、6、12和24小时计算乳酸清除率。

结果

与EP组相比,SFI组的组织因子、凝血酶-抗凝血酶复合物、组织因子途径抑制剂、组织型纤溶酶原激活剂和纤溶酶原激活剂抑制剂1水平显著降低,而抗凝血酶III和蛋白C水平显著升高(均P < 0.05)。此外,与EP组相比SFI组的可溶性血栓调节蛋白和可溶性内皮蛋白C受体水平显著降低(均P < 0.01)。此外,SFI组的动脉乳酸水平显著降低,乳酸清除率更高(均P < 0.01)。

结论

本研究表明SFI可抑制心脏骤停后的凝血-纤溶紊乱,这可能与减轻内皮损伤和改善全身代谢有关。

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