Change of blood coagulation-fibrinolysis system and pharmaceutical effect during basic life support of cardiopulmonary resuscitation in the rabbits
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF EMERGENCY MEDICINE
- Issue:
- 1
- DOI:
- 10.3760/j.issn:1671-0282.2008.01.003
- Key Word:
- 心肺复苏;凝血;纤溶;肝素;尿激酶
Abstract： 目的 观察家兔心脏骤停(CA)后心肺复苏(CPR)的基本生命支持(BLS)阶段中凝血-纤溶改变以及抗凝溶栓药物的干预作用.方法 24只家兔随机分为实验组和对照组,在交流电诱发CA后对照组只进行BLS,实验组在此基础上给予尿激酶和肝素进行干预,分别于诱发CA前(0 min)、CA后5、10、15、20、25、30 min时采血测定凝血酶原时间(PT)、国际标准化比值(INR)、部分凝血活酶活化时间(APTT)、纤维蛋白原(Fib)、凝血酶时间(TT)、纤溶酶原激活物(t-PA)及纤溶酶原激活抑制物-1(PAI-1)和D-二聚体(DD).以全部实验动物诱发CA前所测值为样本估计总体均数的95%置信区间并看作各个观察指标的参考值范围;两组完全随机化设计的计量资料的比较采用t检验;计量资料同组内不同时点之间资料的比较采用配伍资料的方差分析.结果 对照组内动脉血PT、INR、APTT的值在CA后CPR的BLS阶段随时间延长而下降(P＜0.05),TT值、Fib和DD质量浓度变化不明显(P＞0.05),t-PA质量浓度随时间延长不断下降(P＜0.05),PAI-1质量浓度随时间延长而升高(P＜0.05).实验组经抗凝、溶栓药物干预后,PT、INR、APTT和TT的值出现明显升高(P＜0.05),Fib质量浓度随时间延长逐渐下降(P＜0.05),DD、t-PA和PAI-1质量浓度无明显变化(P＞0.05).实验组PT、INR、APTT、TT、t-PA和PAI-1的变化趋势与对照组明显不同(P＜0.05),DD的变化两组相似(P＞0.05).结论 在CA后的BLS阶段出现凝血-纤溶系统功能的动态改变:凝血活性增强,而纤溶活性降低.给予溶栓、抗凝药物的干预可以使血液的抗凝作用和纤溶活性增强,有可能逆转凝血-纤溶功能的失衡或保持凝血-纤溶间的动态平衡.
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