上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (7): 975-.doi: 10.3969/j.issn.1674-8115.2011.07.023

• 论著（临床研究） • 上一篇    下一篇

前列地尔对严重烧伤患者血栓前状态的影响

马 玉1, 袁克俭1, 杨惠忠1, 乔 亮1, 王学锋2   

  1. 上海交通大学 |医学院附属瑞金医院 1.灼伤整形科； 2.临床输血科, 上海 200025
  • 出版日期:2011-07-28 发布日期:2011-07-27
  • 通讯作者: 袁克俭, 电子信箱: yuankejian@126.com。
  • 作者简介:马 玉（1983—）, 女, 硕士生；电子信箱: mayu2011@163.com。
  • 基金资助:

    上海市教委基金（06BZ037）

Effects of liposome prostaglandin E1 on prethrombotic state of patients with severe burn

MA Yu1, YUAN Ke-jian1, YANG Hui-zhong1, QIAO Liang1, WANG Xue-feng2   

  1. 1.Department of Burns, 2.Department of Clinical Blood Transfusion, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2011-07-28 Published:2011-07-27
  • Supported by:

    Shanghai Education Committee Foundation, 06BZ037

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摘要：

目的 观察严重烧伤早期应用前列地尔（Lipo-PGE1）对患者血栓前状态的影响。方法 25例烧伤总面积≥50％总体表面积(TBSA) 和（或）Ⅲ度烧伤面积≥20％TBSA的严重烧伤患者经随机双盲法入选Lipo-PGE1组(n=15)和对照组(n=10)，两组患者入院后均给予常规治疗，Lipo-PGE1组加用Lipo-PGE110 μg静脉推注（1次/d，连用7 d）。分别于烧伤后1、2、3、7、14 d采集血样，测定抗凝血酶抗原(AT：Ag)、抗凝血酶活性(AT：A)、蛋白C活性(PC：A)、蛋白S活性（PS：A)、血小板表面P选择素（P-sel）、可溶性纤维蛋白单体复合物（SFMC）、纤溶酶－抗纤溶酶复合物（PAP）。运用凝血分析仪描记血栓弹力图(TEG)，对Lipo-PGE1组患者用药前后的TEG各项参数进行分析，评估凝血功能。结果 两组患者烧伤后不同时间点的AT：Ag、AT：A、PC：A、PS：A、SFMC和PAP比较差异无统计学意义（P>0.05）；烧伤后3、7 d，LipoPGE1组血小板表面P-sel表达显著低于对照组（P<0.05）。TEG参数分析结果显示：Lipo-PGE1组用药前后的凝血活酶生成时间分别为（3.77±0.90）min和（4.98±0.72）min，用药后较用药前明显延迟（P<0.05）。结论 严重烧伤早期应用Lipo-PGE1可以有效改善患者的血栓前状态。

关键词: 前列地尔, 严重烧伤, 血栓前状态

Abstract:

Objective To observe the effects of liposome prostaglandin E1 (Lipo-PGE1) on prethrombotic state of patients with severe burn. Methods Twenty-five patients with severe burn whose total burn area≥ 50% total body surface area(TBSA) and/or burn area of degree Ⅲ≥ 20% TBSA were randomly divided into Lipo-PGE1 group (n=15) and control group (n=10). Patients in both groups were given conventional treatment after admission, and those in Lipo-PGE1 group were managed with intravenous injection of Lipo-PGE1 (10 μg once a day for 7 d). Blood samples were collected 1 d, 2 d, 3 d, 7 d and 14 d after burn, and antithrombin antigen (AT：Ag), antithrombin activity (AT：A), protein C activity (PC：A), protein S activity (PS：A), P-selectin (P-sel), soluble fibrin monomer complex (SFMC) and plasmin-α2-antiplasmin complex (PAP) were determined. Thromboelastogram (TEG) was recorded with coagulation analyzer, and the parameters of TEG in Lipo-PGE1 group were compared before and after treatment to assess the coagulation function. ResultsThere was no significant difference in AT：Ag, AT：A, PC：A, PS：A, SFMC and PAP between tow groups at different time points after burn (P>0.05). The expression of P-sel in Lipo-PGE1 group was significantly lower than that in control group 3 d and 7 d after burn (P<0.05). Analysis of TEG parameters revealed that the thromboplastin generation time was (3.77±0.90) min before treatment and (4.98±0.72) min after treatment in Lipo-PGE1 group, and the latter was significantly longer than the former (P<0.05). Conclusion Early application of Lipo-PGE1 after severe burn may effectively improve the prethrombotic state.

Key words: liposome prostaglandin E1, severe burn, prethrombotic state