Matthiasson S E, Lindblad B, Mätzsch T, Holst J, Bergqvist D
Department of Surgery, Lund University, Malmö General Hospital, Sweden.
Thromb Haemost. 1994 Mar;71(3):363-5.
An experimental model based on the combination of endothelial damage and flow reduction was used to induce jugular vein thrombosis in rabbits. The effect on thrombosis of a low molecular weight heparin (LMWH [Fragmin]), dextran 70, placebo and their combination was studied in a double-blind fashion with actual doses used in clinical thromboprophylaxis. Saline and polygeline were used as placebo in the control group. Four groups with 120 isolated vein segments in 60 animals were studied for presence of thrombus formation, occlusive thrombi and thrombus weights. Dextran reduced the thrombus weights (p = 0.048) and the formation of occlusive thrombi (p = 0.01), but not the formation of thrombi when compared with the placebo control group. Similarly, LMWH reduced the thrombus weights (p = 0.046), the formation of thrombi (p = 0.007) and occlusive thrombi (p = 0.0001). Compared with the LMWH group the group treated with the combination of LMWH and dextran was found to reduce the frequency of occlusive thrombi (p = 0.03) and numerically, but not significantly, further reduce the overall frequency of thrombosis (p = 0.18) and thrombus weights (p = 0.11). The results are consistent with an augmentation of the antithrombotic effect of LMWH by dextran 70. The need for further evaluation of the combined efficacy of LMWH and dextran is apparent from this study.
采用一种基于内皮损伤与血流减少相结合的实验模型诱导家兔颈静脉血栓形成。以临床血栓预防中实际使用的剂量,采用双盲方式研究了低分子量肝素(LMWH[速避凝])、右旋糖酐70、安慰剂及其联合用药对血栓形成的影响。对照组使用生理盐水和聚明胶肽作为安慰剂。对60只动物的120个分离静脉段进行分组研究,观察血栓形成、闭塞性血栓及血栓重量情况。与安慰剂对照组相比,右旋糖酐可减轻血栓重量(p = 0.048)并减少闭塞性血栓的形成(p = 0.01),但对血栓形成无影响。同样,低分子量肝素可减轻血栓重量(p = 0.046)、减少血栓形成(p = 0.007)及闭塞性血栓的形成(p = 0.0001)。与低分子量肝素组相比,低分子量肝素与右旋糖酐联合治疗组可降低闭塞性血栓的发生率(p = 0.03),并且在数值上可进一步降低血栓形成的总体发生率(p = 0.18)和血栓重量(p = 0.11),但差异无统计学意义。结果表明右旋糖酐70可增强低分子量肝素的抗血栓作用。本研究表明有必要进一步评估低分子量肝素与右旋糖酐联合用药的疗效。