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P2Y12受体抑制剂抗血小板聚集对脓毒症凝血功能影响的研究

Effect of anti platelet aggregation with P2Y12 receptor inhibitor on coagulation function in sepsis

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【作者】 曲凯丽罗前程许磊杭敏郭东风

【Author】 Qu Kaili;Luo Qiancheng;Xu Lei;Hang Min;Guo Dongfeng;Postgraduate Training Base,Gongli Hospital of Pudong New Area,Shanghai City,Ningxia Medical University;Emergency Medicine,Gongli Hospital of Pudong New Area,Shanghai City;

【通讯作者】 郭东风;

【机构】 宁夏医科大学上海市浦东新区公利医院研究生培养基地上海市浦东新区公利医院急诊医学科

【摘要】 目的:利用脂多糖(LPS)建立小鼠脓毒症模型,探讨P2Y12受体抑制剂(氯吡格雷)对脓毒症凝血功能的影响。方法:将24只小鼠随机等分为四组,分别为空白对照组、LPS组、氯吡格雷LPS诱导组和LPS氯吡格雷治疗组。通过单次腹腔注射LPS(15 mg/kg)0.1 m L/只制备小鼠脓毒症模型,氯吡格雷灌胃(15 mg/kg)1 m L/只,以首次腹腔注射记为"0 h"分别在4 h、12 h、24 h、48 h采血进行血小板数量(PLT)、血小板平均体积(MPV)、白细胞数量(WBC)及凝血纤溶指标水平检测。结果:LPS氯吡格雷治疗组4 h时点MPV水平高于LPS组,且凝血酶-抗凝血酶复合物(TAT)水平低于LPS组,差异有统计学意义(P<0.05)。氯吡格雷LPS诱导组各时点PLT和WBC水平均高于LPS组,4 h MPV水平高于LPS组,24 h TAT水平低于LPS组,4 h和24 hD-二聚体(DD)水平均低于LPS组,4 h组织纤维蛋白(原)降解产物(FDP)水平低于LPS组,差异均有统计学意义(P<0.05)。结论:P2Y12受体抑制剂氯吡格雷可通过抑制血小板聚集改善脓毒症凝血、纤溶功能异常。

【Abstract】 Objective:To investigate the effect of P2 Y12 receptor inhibitor(clopidogrel) on coagulation function in sepsis with establishment of mouse sepsis model by lipopolysaccharide(LPS).Methods:24 mice were randomly divided into four groups:blank control group,LPS group,clopidogrel LPS induction group and LPS clopidogrel treatment group.The sepsis model was established by single intraperitoneal injection of LPS(15 mg/kg) of 0.1 m L/case,intragastric administration of clopidogrel(15 mg/kg) 0.1 ml/case,the first intraperitoneal injection was recorded as "0 hour",blood samples were collected at 4 hours,12 hours,24 hours and 48 hours for PLT,MPV,WBC,coagulation and fibrinolysis index level testing.Results:In the LPS clopidogrel treatment group,the MPV level at 4 hours was higher than that in the LPS group,and the TAT level was lower than that in the LPS group,the difference was statistically significant(P<0.05).In the clopidogrel LPS induction group,the levels of PLT and WBC at all time points were higher than those in the LPS group,the level of MPV at 4 hours was higher than that in the LPS group,the level of TAT at 24 hours was lower than that in the LPS group,the level of DD at 4 hours and 24 hours was lower than that in the LPS group,and the level of FDP at 4 hours was lower than that in the LPS group,the difference was statistically significant(P<0.05).Conclusion:P2 Y12 receptor inhibitor clopidogrel can improve coagulation and fibrinolysis in sepsis by inhibiting platelet aggregation.

【基金】 上海市浦东新区卫生系统优秀青年医学人才培养项目(PWRq2017-09);上海市卫生和健康委员会科研项目(201640405);上海市浦东新区卫生系统重点专科建设项目(PWZzk2017-05)~~
  • 【文献出处】 中国社区医师 ,Chinese Community Doctors , 编辑部邮箱 ,2021年14期
  • 【分类号】R459.7
  • 【下载频次】143
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