Wu Ren-Chieh, Chou Ping-Tse, Chen Li-Kuang
Department of Emergency Medicine, Tzu Chi Medical Center, Hualien, Taiwan.
Department of Laboratory Diagnosis, School of Medicine, Tzu Chi University, Hualien, Taiwan.
Thromb J. 2016 Oct 4;14(Suppl 1):38. doi: 10.1186/s12959-016-0093-1. eCollection 2016.
Thrombosis and coagulopathy are the commonest hematological manifestations of envenomation of Russell's viper venom (RVV). Factor X is activated by a factor X-activating enzyme from Russell's viper venom (RVV-X) to start the coagulation cascade. We established an animal model with local ischemic effects induced by RVV. We tried to treat RVV envenomation with antiplatelets and anticoagulants without recourse to antivenom.
RVV was injected into the foot pad of mice. We observed the effects at different intervals and compared local changes in ischemia with drug treatment after 30 min.
A combination of aspirin plus tirofiban could prevent the ischemic change induced by RVV. The antithrombotic effects of single-use of aspirin or tirofiban were better than single-use of heparin or clopidogrel.
The aspirin + tirofiban group had a better outcome with respect to prevention of tissue ischemia and gangrene. This indicates that the activation and aggregation of platelets is the major cause of thrombosis induced by RVV.
血栓形成和凝血病是罗素蝰蛇毒（RVV）中毒最常见的血液学表现。X因子由罗素蝰蛇毒中的X因子激活酶（RVV-X）激活，从而启动凝血级联反应。我们建立了一个由RVV诱导局部缺血效应的动物模型。我们尝试使用抗血小板药物和抗凝剂治疗RVV中毒，而不使用抗蛇毒血清。
将RVV注射到小鼠的足垫中。我们在不同时间间隔观察效果，并在30分钟后比较药物治疗后局部缺血的变化。
阿司匹林加替罗非班联合使用可预防RVV诱导的缺血变化。单次使用阿司匹林或替罗非班的抗血栓作用优于单次使用肝素或氯吡格雷。
阿司匹林+替罗非班组在预防组织缺血和坏疽方面有更好的效果。这表明血小板的激活和聚集是RVV诱导血栓形成的主要原因。
