不同剂量羟乙基淀粉130/0.4对严重脓毒症大鼠凝血功能的影响
Effect of hydroxyethyl starch 130/0.4 solutions with different volume on coagulant function in rats with severe sepsis
目的 探讨不同剂量6%羟乙基淀粉130/0.4(HES130/0.4)对严重脓毒症大鼠凝血功能的影响.方法 80只成年健康雄性SD大鼠按随机数字表法分为对照组、脓毒症组(CLP组),再进一步分为Ho、H1、H2、H34个小组(n=10);CLP组采用经典盲肠结扎穿孔(CLP)术复制严重脓毒症大鼠模型,对照组除不结扎穿孔盲肠外,余同.CLP术4h后H1、H2、H3组分别输注不同剂量HES130/0.4,液体复苏前、复苏后4h监测动脉血气、血常规、常规凝血、血栓弹力图(TEG).结果 与对照组比,CLP组PO2差异无统计学意义,CLP组pH、PCO2、MAP显著低于对照组,Lac显著高于对照组(P<0.05),CLP组APTT 、PT显著高于对照组(P<0.05),D-Dime、FIB无明显变化(P>0.05),CLP组R、K显著短于对照组,MA显著高于对照组(P<0.05),α、CI虽高于对照组但差异无统计学意义(P>0.05).CLP组内,与Ho比较,H1与H2中R缩短,K延长,α减小,MA、CI增大,H3中R、K延长,α、MA、CI减小,但差异均无统计学意义(均P>0.05).结论 中小剂量(<30 ml/kg)6%羟乙基淀粉130/0.4用于严重脓毒症大鼠早期液体复苏对凝血功能影响较小.
更多Objective Aim to determine the effect of different dose of 6% 130/0.4 hydroxyethyl starch on coagulation function in rats model with severe sepsis by cecal ligation and puncture (CLP).Method 80 male SD rats were selected and randomly divided into the sham groups and the CLP groups,every group was divided into 4 small Groups again:before recovery(H0),7.5 ml/kg group(H1),15 ml/kg group (H2) and 30 ml/kg group(H3),n =10; The CLP groups were established by cecal ligation and perforation (CLP),the sham groups were the same as the CLP groups except for CLP,MAP was monitored for all rats during the experiment.After 4 hours by CLP,Procedure fluid resuscitation which received 6% hydroxyethyl starch 130/0.4 by respectively 7.5 ml/kg,15 ml/kg,30 ml/kg were started at a rate of 10 ml · kg-1 · h-1,the sham groups were the same dose 6% hydroxyethyl starch 130/0.4 at the same time.All rats were taken for arterial blood harvest at 4 h after fluid infusion for arterial blood gases,blood routine examination,conventional coagulation function and thrombelastography (TEG).Results Compared with the sham groups,PO2 in the CLP groups was not significantly different.pH,PCO2 and MAP were significantly lower than the sham groups,Lac was significantly higher than the sham groups (P < 0.05).APTT and PT were significantly higher than the sham groups (P < 0.05),D-Dime and FIB were not significant different (P > 0.05),R and K were significantly shorter than the sham groups,MA was significantly higher than the sham groups (P < 0.05),α and CI were higher than the sham groups,but the difference was not statistically significant (P > 0.05).Within CLP group,compared with H0,R,K,α,MA and CI after fluid resuscitation were not significant different.Conclusion Low-dose (less than 30 ml/kg) 6% hydroxyethyl starch 130/0.4 in early fluid resuscitation have less effect on coagulation function in rats with severe sepsis.
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