人工寒潮促发大鼠脑卒中发病前的凝血和纤溶系统功能的变化

目的探讨人工寒潮促发大鼠脑卒中发病前的凝血和纤溶系统功能的变化。方法210只SD大鼠制成双肾双夹肾血管性高血压大鼠（2 kidney 2 clip renovascular hypertensive rats，RHR）模型，分为寒潮和非寒潮两大组，再按血压水平各分为正常血压组、160mmHg～199mmHg、200mmHg～219mmHg和≥220mmHg等4个亚组，寒潮箱处理3天后取血检测血浆凝血酶激活的纤溶抑制物（thrombin-activatable fibrinolysis inhibitor，TAFI）、蛋白C（protein C，PC）、凝血酶-抗凝血酶复合物（thrombin-antithrombin complexes，TAT）及纤溶酶-α2抗纤溶酶复合物（plasmin／alpha-2-anti-plasmin complexes，PAP）水平，鼠脑连续切片经HE染色了解是否有卒中病灶，发生脑卒中者被剔出卒中前状态的分析。结果①血压〈220mmHg亚组，寒潮组的血浆TAT、PAP水平比非寒潮组均有升高趋势，但仅200-219mmHg亚组的血浆PAP水平的差异有统计学意义（P〈0．05）；②在≥220mmHg血压亚组，寒潮组的血浆TAT、PAP水平比非寒潮组均有降低趋势，P〈0．05；③在非寒潮组，血浆TAT、PAP水平均随血压升高而升高，P〈0．05；④在寒潮组，血浆TAT、PAP水平在〈220mmHg时均随血压升高而升高，然而在≥220mmHg时转为降低，P〈0．05；⑤血浆TAFI与PC水平的变化趋势与TAT、PAP一致，但差异无统计学意义。结论长期持续的高血压损害了RHR凝血、纤溶系统的调控功能，血压越高调控功能越差。

The Changes of Coagulation and Fibrinolysis in Rats with Prestroke Status Caused by Artificial Cold

Objective To study the changes of coagulation and fibrinolysis in rats with prestroke status caused by artificial cold. Methods Male Sprague-Dawley （SD） rats （n=210） were randomly assigned into 2 groups： artificial cold exposure （ACE） and non-ACE. Each group was further divided into 4 sub-groups according to their SBP after 2 kidney 2 clip renovascular hypertensive rats （RHR） operation before the ACE treatment]： ① Sham-operated control group, BP 〈 140 mmHg, ② mild hypertensive group, BP of 160-199 mmHg, ③ moderate hypertensive group, BP of 200-219 mmHg, and ④severe hypertensive group, BP≥ 220 mmHg. To establish the ACE and non-ACE treatment, the RHR were housed individually in a modified RXZ-300A intelligent artificial climate cabinet. The ACE was designed as 3 cycles of 12 h light of 22℃ and 12 h dark of4℃. The non-ACE group was kept at 22 ℃ throughout the experiment. Plasma was collected for measure of thrombin-activatable fibrinolysis inhibitor （TAFI）, protein C （PC）, thrombin-antithrombin （TAT） complexes and plasmin/alpha-2-anti-plasmin （PAP） complexes with ELISA or chromogenic assay. Rat brains were terminally sectioned and stained with hematoxylin-eosin （HE） for routine light microscopic observation. The rats with stroke did not enter the statistical analysis. Results In BP 〈 220 mmHg subgroup, all indexes were elevated in rats with ACE treatment compared with those with non-ACE treatment, but only the difference in PAP in 200 - 219 mmHg subgroup was significant. On the other hand, all the indexes in BP ≥220 mmHg subgroup decreased to some extent in rats with ACE treatment compared with those with non-ACE treatment, but only the difference in TAT and PAP was significant. Among rats with not-ACE treatment, there is a positive association between high blood pressure and levels of TAT and PAP. Among rats with ACE treatment, this positive association can also be seen in rats with BP〈220 mmHg, however, all indexes de-creased dramatically in rats wi