血栓通注射液对LPS诱导的兔弥散性血管内凝血的拮抗作用

 目的：研究血栓通注射液对脂多糖（LPS）诱导的兔弥散性血管内凝血（DIC）的影响。方法：对兔耳缘静脉持续滴注LPS以建立兔DIC模型,记录各组动物在24 h后的生存率;全自动血浆分析仪测定丙氨酸氨基转移酶(ALT)和血尿素氮(BUN);用全自动凝血分析仪检测活化部分凝血活酶时间（APTT）和凝血酶原时间（PT）;用凝固法测定纤维蛋白原含量;全自动血细胞分析仪进行血小板计数;发色底物法测定蛋白C和抗凝血酶Ⅲ的活性;ELISA法检测血浆中肿瘤坏死因子α（TNF-α）的含量。结果：持续从兔耳缘静脉滴注LPS后,DIC模型组动物大量死亡,ALT和BUN显著升高,APTT和PT显著延长,蛋白C和抗凝血酶Ⅲ的活性明显降低,血小板计数明显减少,血浆中TNF-α的含量显著升高。注射血栓通注射液后,动物的死亡率明显下降,ALT和BUN明显下降,APTT和PT明显缩短,血小板计数明显上升,纤维蛋白原含量显著提高,蛋白C和抗凝血酶Ⅲ活性明显提升;血浆TNF-α的含量明显降低。结论：血栓通注射液对LPS所诱导的兔DIC有良好的拮抗作用。     

复方丹参注射液抗脂多糖诱导的兔弥漫性血管内凝血

目的: 研究复方丹参注射液对脂多糖(LPS)诱导的兔弥漫性血管内凝血(DIC)的作用。方法: 用LPS诱导兔DIC模型。凝固法测定纤维蛋白原含量,全自动凝血分析仪检测活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)和纤维蛋白原含量;全自动血细胞分析仪进行血小板计数;全自动血浆分析仪测定谷丙转氨酶(ALT)以及血尿素氮(BUN);发色底物法测定蛋白C及抗凝血酶Ⅲ的活性。观察复方丹参注射液对LPS诱导的兔DIC的拮抗作用。结果: 兔耳缘静脉持续滴注LPS,观察到:APTT和PT显著延长;血小板计数和纤维蛋白原含量明显减少;ALT和BUN显著升高;蛋白C和抗凝血酶Ⅲ的活性明显降低。给予复方丹参注射液后,APTT和PT的延长明显缩短;血小板计数和纤维蛋白原的含量均明显恢复;ALT和BUN显著下降;蛋白C及抗凝血酶Ⅲ的活性显著改善。结论: 复方丹参注射液对LPS诱导的兔DIC有良好的拮抗作用。     

清开灵注射液对LPS诱导的兔弥散性血管内凝血的作用

目的: 研究清开灵注射液对脂多糖(LPS)诱导的兔弥散性血管内凝血(DIC)的作用。方法: 采用耳缘静脉持续滴注LPS的方法建立兔弥散性血管内凝血模型,观察各组动物24 h内各时点生存率;采用全自动凝血分析仪检测活化部分凝血活酶时间(APTT)和凝血酶原时间(PT);凝固法测定纤维蛋白原含量;全自动血细胞分析仪进行血小板计数;全自动血浆分析仪测定丙氨酸氨基转移酶(ALT)以及血尿素氮(BUN);发色底物法测定蛋白C及抗凝血酶Ⅲ的活性;ELISA法检测血浆肿瘤坏死因子α(TNF-α)含量。结果: 兔静脉持续滴注LPS后,APTT和PT显著延长,ALT和BUN显著升高,蛋白C和抗凝血酶Ⅲ的活性明显降低,血小板计数显著减少,血浆TNF-α含量显著升高。给予清开灵注射液后,APTT和PT的延长明显缩短,血小板计数、纤维蛋白原含量、蛋白C及抗凝血酶Ⅲ活性均明显恢复;ALT、BUN以及血浆TNF-α含量明显降低。结论: 清开灵注射液对LPS所诱导的兔弥散性血管内凝血有良好的拮抗作用。     

重症肝病患者凝血和纤溶指标观察

重症肝病患者因肝细胞的严重损害,致使肝脏功能减退,全身各系统受损,凝血系统发生不同程度的异常改变。本文报道48例重症肝病（包括慢性重症肝炎和肝硬化）患者血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（Fib）、凝血酶时间（TT）、D-二聚体（D-D）、抗凝血酶-Ⅲ（AT—Ⅲ）、纤溶酶原（PLG）和血小板计数（PLT）的检测结果,观察重症肝病患者凝血、抗凝和纤溶功能变化。     

中药脑血宝制剂对凝血和血小板聚集率的影响

目的和方法:本研究在体内、体外实验的基础上,通过测定血浆中活化的部分凝血活酶时间(APTT)、凝血酶原时间(PT)、抗凝血酶III(AT-Ⅲ)活性、凝血酶时间(TT)、纤维蛋白原(Fng)、纤溶酶原(Plg)的变化以及血浆中血小板聚集率来观察脑血宝制剂对血液凝固过程不同阶段和血小板聚集率的影响,分析其抗血栓作用的机制。结果:脑血宝预防组,血浆中APTT、PT均比血栓组延长(P＜0.05,P＜0.01),AT-Ⅲ的活性高于血栓组(P＜0.05,P＜0.01),Fng含量低于血栓组,TT延长,Fng和TT呈负性相关关系,血小板聚集率明显低于血栓组(P＜0.05,P＜0.01)。结论:脑血宝制剂对凝血的多个环节均有抑制作用,从而对抗血栓的形成。     

紫杉醇联合卡铂化疗对卵巢癌凝血/纤溶及CA125/HE4水平的调控及临床意义

目的：探讨紫杉醇联合卡铂联合化疗对卵巢癌（OC）凝血/纤溶及肿瘤标志物的影响及临床意义。方法：研究分为OC联合化疗（CC）和良性卵巢肿瘤对照（control）组，各组50例。借助苏木精-伊红（HE）染色和透射电镜（TEM）观察卵巢病理学改变；采用全自动凝血分析仪及凝固法检测凝血酶原时间（PT-SEC）、凝血酶原国际标准比值（PT-INR）、凝血酶原时间比值（PT-RATIO）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）及抗凝血酶-Ⅲ（AT-Ⅲ）水平；免疫比浊法测定纤维蛋白（原）降解产物（FDP）和D-二聚体（D-D）含量；采用电化学发光法检测糖类抗原125(CA125)和人附睾蛋白4(HE4)水平；并绘制受试者工作特征（ROC）曲线，以分析凝血/纤溶产物与肿瘤标志物的相关性。结果：光镜显示卵巢浆液性癌（SC）细胞坏死和腺腔样结构，超微结构显示线粒体显著肿胀和嵴溶解，联合化疗后卵巢SC呈现正常线粒体与“脂质空泡”并存的现象。凝血与纤溶指标检测显示，OC患者化疗前TT和AT-Ⅲ水平显著降低（P<0.01）,APTT、FIB、FDP、D-D、CA125和...     

蝮蛇毒蛋白C激活物对家兔实验性DIC的干预作用

目的:观察蝮蛇毒蛋白C激活物(PCA)对家兔实验性弥散性血管内凝血(DIC)的干预作用并探讨其作用机理。方法:健康青紫蓝家兔24只随机分为:正常对照组、DIC组、PCA干预组(n=8),采用耳缘静脉注射兔脑粉浸液建立DIC模型,检测各组的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fbg)含量和血小板计数(PLT)。结果:与正常对照组相比,DIC组PT、APTT延长的百分率、TT缩短的百分率、Fbg、PLT显著升高(P0.01);PCA干预组PT、APTT延长的百分率,TT缩短的百分率与Fbg、PLT降低的百分率均明显降低(P0.01)。结论:蝮蛇毒PCA对家兔实验性DIC有一定的防治作用,其机制可能与PCA抗凝、抑制血小板聚集有关。     

慢性肾功能不全患者凝血指标的检测与分析

本文对68例慢性肾功能不全患者凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fib）含量和抗凝血酶（AT）活性进行检测分析，结果报道如下。     

标本采集量不足对凝血检测项目结果的影响

目的 分析标本采集量不足对凝血检测项目结果的影响.方法 收集采集量不足及足量采血的对照组标本共23对,分别检测凝血酶原时间(PT),活化部分凝血活酶时间(APTT),凝血酶时间(TT),纤维蛋白原(FIB),D-二聚体(D-Dimer)和纤维蛋白/纤维蛋白原降解产物(FDP)的含量.结果 采血量不足组与对照组相比PT、APTT、TT显著延长,FIB和D-Dimer含量显著降低,而FDP含量没有明显变化.结论 凝血标本采集量不足会影响检测结果的准确性.     

不同孕期妇女常规凝血指标的变化及临床意义

妊娠是妇女的一段特殊生理时期，机体的各项生理指标烩有所变化，随着孕月的增加，特别是妊娠中、晚期，体内凝血成分和纤维蛋白溶解活性出现明显改变，凝血活性增强或抗凝血活性减弱，均会导致高凝状态。本文对不同孕期妇女的血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）和纤维蛋白原（Fib）进行检测，以进一步探讨妊娠妇女凝血指标的变化及临床意义。     

AN IMMUNOHISTOCHEMICAL STUDY OF EXPERIMENTAL DISSEMINATED INTRAVASCULAR COAGULATION (DIC)

The experiment was focused on clarifying changes in fibrin or fibrinogen related materials (FRMs) in blood, urine, and renal tissues of rats with disseminated intravascular coagulation (DIC). DIC was induced by a continuous infusion of massive volume of physiologic saline (100 ml) immediately after endotoxin injection. FRM response was checked by biochemical and histo-chemical examinations at various intervals. In the blood of DIC rats, platelet and fibrinogen levels initially decreased, followed by an increasing plasma fibrin degradation products (FDP). Parallel with elevation of blood FDP the percentage of glomeruli with FRMs increased. Thereafter, FRMs were observed in renal tubuli and urine. Our observations indicated that FRMs in renal tubuli were derived from glomerular capillaries via Bowman's space. In conclusion, in DIC the immunoenzymehistochemical (IEH) procedure appeared necessary for an accurate pathological diagnosis, and the presence of FRMs in renal tubuli appeared to be an important finding even in absence of FRMs in glomeruli.     

An immunohistochemical study of experimental disseminated intravascular coagulation (DIC)

The experiment was focused on clarifying changes in fibrin or fibrinogen related materials (FRMs) in blood, urine, and renal tissues of rats with disseminated intravascular coagulation (DIC). DIC was induced by a continuous infusion of massive volume of physiologic saline (100 ml) immediately after endotoxin injection. FRM response was checked by biochemical and histochemical examinations at various intervals. In the blood of DIC rats, platelet and fibrinogen levels initially decreased, followed by an increasing plasma fibrin degradation products (FDP). Parallel with elevation of blood FDP the percentage of glomeruli with FRMs increased. Thereafter, FRMs were observed in renal tubuli and urine. Our observations indicated that FRMs in renal tubuli were derived from glomerular capillaries via Bowman's space. In conclusion, in DIC the immunoenzymehistochemical (IEH) procedure appeared necessary for an accurate pathological diagnosis, and the presence of FRMs in renal tubuli appeared to be an important finding even in absence of FRMs in glomeruli.     

正常妊娠妇女凝血、抗凝与纤溶指标的测定及意义

目的 :探讨孕妇妊娠期机体凝血、抗凝、纤溶系统的改变及其生理和病理意义。方法 :凝固法测定凝血酶原时间 (PT)、活化部分凝血活酶时间 (APTT)和凝血酶时间 (TT) ;发色底物法测定纤维蛋白原 (Fib)、抗凝血酶Ⅲ (AT Ⅲ )、蛋白C(PC)和蛋白S(PS) ;ELISH法测定纤维蛋白降解产物 (FDP)和D 二聚体 (D D)。结果 :5 0例妊娠 2 8～ 32周的孕妇 (妊娠组 )与 5 0例正常非孕妇女 (对照组 )相比 ,妊娠组凝血指标PT、APTT、TT时间 ( 9.6 0s± 2 .5 4s、2 8.90s± 3.75s、11.6s± 3.5 4s)显著缩短 (对照组分别是 12 .10s± 2 .15s、31.5 0s±4 .4 6s、4 .2 0s± 2 .18s) ;孕妇组抗凝指标AT Ⅲ、PC、PS活性 ( 88.75 %± 13.4 7%、91.85 %± 2 5 .32 %、89.6 4 %± 19.88% )明显降低 (对照组分别是 99.5 5 %± 11.2 4 %、10 4 .33%±32 .88%、10 3.5 6 %± 2 2 .5 8% ) ;Fib、FDP、D D含量均明显升高 (P <0 .0 5或P <0 .0 1)。结论 :妊娠期妇女凝血、抗凝及纤溶功能发生改变 ,表现为凝血功能增强 ,抗凝功能降低 ,出现所谓妊娠期高凝状态。这一妊娠期生理变化为产后快速有效止血提供了物质基础 ,但也可能是导致妊娠期血栓病发生的重要原因     

Fibrin monomer assay

Quantitative assay for fibrin monomer was done by use of a chromogenic substrate (S-2390, Coa set fibrin monomer). Samples from DIC prone patients with the underlying disease were assayed and classified into four groups. The pre DIC group showed higher FM values than the control with no laboratory coagulation abnormality, although the FDP . D-dimer showed no significant rise. FM assay is a useful marker for the detection of early coagulopathy in DIC. Administration of the AT III concentrate in the case of low level of plasma ATIII, thrombin . antithrombin complex I (TAT) caused a significant transient rise. The clinical course of DIC by TAT is often affected by the fluctuation of ATIII level in plasma, the usefulness of FM is that it reflects the real thrombin generation in DIC.     

Criteria for diagnosing DIC

The differences between reagents of prothrombin time (PT), fibrinogen and fibrin and fibrinogen degradation products(FDP) were examined in patients with disseminated intravascular coagulation (DIC) and without DIC. The sensitivity of the PT ratio for DIC is lowered by the PT reagent with a high international sensitivity index, and the difference between PT reagents was marked. The sensitivity of PT-international normalized ratio (INR) for DIC was higher than that of the PT ratio and the difference between reagents in PT-INR was low. Though the difference between reagents for fibrinogen is slight, the usefulness in diagnosing DIC is also slight. Though the sensitivity of FDP for DIC was good, the difference between FDP reagents was marked. Therefore, standardization of PT and FDP seems to be necessary. Concordance of overt-DIC diagnostic criteria by the International Society of Thrombosis and Haemostasis (ISTH) and DIC diagnostic criteria of Japanese Ministry of Health and Welfare (JMHW) was about 70%, and overt-DIC diagnostic criteria of ISTH seemed to diagnose the typical type of DIC diagnosed by JMHW criteria. Finally, the diagnostic criteria of non-overt DIC are expected to become increasingly important.     

Diagnostik der disseminierten intravasalen Gerinnung: Aussagekraft von löslichem Fibrin,D-Dimeren und Fibrin(ogen)-Spaltprodukten

Summary The validity of the fibrin(ogen) derivatives soluble fibrin, D-dimers and fibrin(ogen) degradation products was compared with other parameters in early and sensitive diagnosing of disseminated intravascular coagulation (DIC). In a clinical study 900 patients' samples from separate, defined groups were examined, including course observations of intensive care patients (n=38) and patients with acute pancreatitis. The fibrin(ogen) derivatives correlated very well with the degree of blood coagulation disturbances: in particular, D-dimers and soluble fibrin proved to be more sensitive in early diagnosis of DIC than other parameters. The SF-PS-turbidimetry demonstrated a good validity and practicality in the quantitative determination of soluble fibrin, but a suitable analyzer is essential. Determination of D-dimers is preferable to that of fibrin(ogen) degradation products (both in the latex-agglutination test) because of the better sensitivity and practicality; even more sensitive results were provided by the D-dimer-ELISA, which is, however, not practical in acute diagnostics. The decrease in protein C was at least equally sensitive as the antithrombin III-levels in indicating the consumption of the hemostatic potential. The decrease of thrombocyte counts and fibrinogen levels could first be detected in a later stage of DIC.In conclusion, D-dimers and soluble fibrin can improve the DIC diagnostics, making them more reliable; additionally, antithrombin III and possibly protein C deserve further consideration, although the fibrin(ogen) derivatives are apparently of greater importance.

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Abkürzungsverzeichnis ATIII Antithrombin III - DIC disseminierte intravasale Gerinnung - ELISA Enzyme-linked Immuno Sorbent Assay - FII, FV, FXIII Gerinnungsfaktor II, V, XIII - FDP Fibrin(ogen)-Spaltprodukte - FPA Fibrinopeptid A - LAT Latex-Agglutinationstest - PS Protaminsulfat - PTT partielle Thromboplastinzeit - tPA Gewebeplasminogen-Aktivator - TAT Thrombin-AntithrombinIII-Komplex - TPZ Thromboplastin-Zeit     

Measurement of plasma fibrin D-dimer levels with the use of a monoclonal antibody coupled to latex beads

Recently, monoclonal antibody (DD-3B6) to fibrin D-dimer was prepared and coupled to latex beads to provide a specific test (Dimertest) for fibrinolysis. The purpose of this study was to evaluate the Dimertest assay as a clinical laboratory test for the measurement of plasma fibrin D-dimer derivatives. The Dimer-test assay specifically detected 2 micrograms/mL of purified fibrin D-dimer or fibrin D-dimer/fragment E complex added to afibrinogenemic plasma but did not detect 500 micrograms/mL of either fibrinogen fragments X, D, E, or 160 micrograms/mL cross-linked fibrinogen. The fibrin(ogen) degradation product (FDP) assays of American Dade or Wellcome Diagnostics detected 5.0 micrograms/mL of fibrin D-dimer and from 1 to 10 micrograms/mL of the other FDPs. Twenty-eight percent of 150 random plasma samples assayed from hospitalized patients were positive for fibrin D-dimer derivatives. Plasma samples from 152 patients suspected of having disseminated intravascular coagulation (DIC) were assayed for serum FDP (Wellcome Diagnostics) and plasma fibrin D-dimer derivatives. Samples from 69% of patients with serum FDP levels less than 10 micrograms/mL, and more than 90% of those with serum FDP levels greater than 10 micrograms/mL, were positive for fibrin D-dimer derivatives. Dimertest results were not modified by heparin, streptokinase, freeze-thawing, or clotting plasma. Serum fibrinogen-related antigens were immunoadsorbed from Dimer-test positive sera by anti-fibrinogen antibody and formalin-fixed Cowan I strain Staphylococcus aureus. Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and protein blotting with the use of monoclonal antibody DD-3B6 demonstrated a protein band with similar mobility to purified D-dimer. The measurement of plasma fibrin D-dimer derivatives by the Dimertest assay is a rapid, sensitive, and specific laboratory test for fibrinolysis. The Dimertest assay has proven to be a useful addition to the clinical laboratory and should be helpful in the diagnosis and management of patients with diseases associated with fibrinolysis.