Öahin Abdullah, Özer Nazmi
MD, Department of General Surgery, Adana City Training and Research Hospital, Turkey. Acquisition, analysis and interpretation of data; histopathological examinations; critical revision; final approval.
Associate Professor, Department of General Surgery, University of Health Sciences, Adana City Training and Research Hospital, Turkey. Substantive scientific and intellectual contributions to the study, conception and design, technical procedures, statistics analysis, manuscript preparation and writing, final approval.
Acta Cir Bras. 2020 Dec 18;35(11):e351102. doi: 10.1590/ACB351102. eCollection 2020.
In this experimental study, activated protein C (APC), which has anticoagulant, antithrombotic, profibrinolytic, anti-inflammatory and antiapoptotic properties, was used to prevent coagulopathy in a disseminated intravascular coagulation (DIC) model formatted with lipopolysaccharide (LPS) infusion.
Twenty-five Wistar albino rats weighting 280 - 320 g each were used. They were randomly divided into three groups: sham, control and study groups. To sham group (n = 5), only normal saline was infused. To control (n = 10) and study groups (n = 10), 30 mg/kg LPS was infused for 4 h from femoral vein. After LPS infusion, 100 µg/kg recombinant APC was given during 4 h in study group. Eight hours later, blood samples were taken from abdominal aorta and the animals sacrificed. From these samples, platelet, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and D-dimer levels were studied.
Platelet counts and fibrinogen levels were significantly lower in control and study groups than sham group (p < 0.05). The PT, aPTT and D-dimer levels were significantly higher in control and study groups than in sham group (p < 0.05). When comparing control and study groups, platelet counts were not statistically different (p = 0.36). However, the difference of the fibrinogen levels was significant between these groups (p = 0.0001). While PT and aPTT were longer in the study group compared to the control group (p < 0.05), D-dimer levels were lower in the study group than in control (p = 0.0001).
Use of APC can prevent hypercoagulation and consumption coagulopathy in the DIC as a result of correcting hematological parameters other than prolongation of coagulation time.
在本实验研究中,具有抗凝、抗血栓形成、促纤溶、抗炎和抗凋亡特性的活化蛋白C(APC)被用于预防通过输注脂多糖(LPS)构建的弥散性血管内凝血(DIC)模型中的凝血病。
使用25只体重为280 - 320克的Wistar白化大鼠。它们被随机分为三组:假手术组、对照组和研究组。给假手术组(n = 5)仅输注生理盐水。给对照组(n = 10)和研究组(n = 10)从股静脉输注30毫克/千克的LPS,持续4小时。在输注LPS后,研究组在4小时内给予100微克/千克的重组APC。8小时后,从腹主动脉采集血样并处死动物。对这些样本研究血小板、凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)、纤维蛋白原和D - 二聚体水平。
对照组和研究组的血小板计数和纤维蛋白原水平显著低于假手术组(p < 0.05)。对照组和研究组的PT、aPTT和D - 二聚体水平显著高于假手术组(p < 0.05)。当比较对照组和研究组时,血小板计数无统计学差异(p = 0.36)。然而,这些组之间纤维蛋白原水平的差异显著(p = 0.0001)。与对照组相比,研究组的PT和aPTT更长(p < 0.05),而研究组的D - 二聚体水平低于对照组(p = 0.0001)。
APC的使用可通过纠正除凝血时间延长之外的血液学参数来预防DIC中的高凝状态和消耗性凝血病。