6％羟乙基淀粉130／0．4对脓毒症大鼠凝血功能的影响

目的]观察6％羟乙基淀粉130/0．4对脓毒症大鼠凝血四项和血小板的影响。方法]利用盲肠结扎穿孔术（CLP）制备脓毒症动物模型。80只SD大鼠随机分为4组：正常组（ n ＝8）、假手术组（Sham组，行假手术后3 h用生理盐水作为输注液体，n ＝24）、模型组（SEP组，造脓毒症模型后3 h用生理盐水作为复苏液体，n＝24）和羟乙基淀粉组（HES组，造脓毒症模型后3 h用6％羟乙基淀粉130/0．4作为复苏液体，n＝24）。后三组按采样时间再分为手术后6 h、12 h、24 h三个亚组，每组8只。各组于相应3个时间点经心脏采血，测定大鼠的凝血酶原时间（PT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）和血小板计数（PLT ）的变化。结果]与正常组相比，Sham组凝血四项指标和PLT手术前后相比较无明显变化（ P ＞0．05）。与Sham组相比，SEP组、HES组在各时间点PT、TT、APTT 明显延长（ P均＜0．05），FIB、PLT 明显减少（ P均＜0．05），但12 h、24 h HES组PT、TT、APTT 升高程度及FIB、PLT 降低程度较SEP组小，且差异有显著性（ P均＜0．05）。结论]早期应用羟乙基淀粉130/0．4可有效改善脓毒症的凝血功能障碍，一定程度上可缓解脓毒症的进一步发展。

Effect of Hydroxyethyl Starch 130/0 .4 on Coagulation Function of Rats with Sepsis

Objective] To observe the effect of hydroxyethyl starch（HES） 130/0 .4 on 4 coagulation pa-rameters and platelet count（PLT） in sepsis rats .Methods]Cecum ligation perforatio（CLP） was used to es-tablish animal models with sepsis .A total of 80 healthy SD rats were randomly divided into four groups inclu-ding normal group（ n =8） ,sham operation group（sham group ,n =24） ,model group（SEP group ,n =24） and HES group（ n =24） .Sham group was injected with normal saline 3h after operation .SEP group was in-jected with normal saline as resuscitation fluid 3h after the establishment of sepsis model .HES group was in-jected with 6% HES 130/0 .4 3h after the establishment of sepsis model .According to sacrifice time ,the later 3 groups were divided into postoperative 6h ,12h and 24h subgroups with 8 rats in each subgroup .Blood sam-ples in each group were drawn from heart at different time .Prothrombin time（PT） ,thrombin time（TT） ,acti-vated partial thrombin time（APTT） ,fibrinogen（FIB） and PLT in rats were examined .Results]Compared with normal group ,4 coagulation parameters and PLT in sham group had no obvious change before and after operation（ P＆gt;0 .05） .Compared with sham group ,PT ,TT and APTT in SEP group and HES group at each time point were prolonged obviously （all P ＆lt; 0 .05） ,but FIB and PLT were decreased obviously （all P ＆lt;0 .05） ,but the elevation of PT ,TT and APTT and the decreasing of FIB and PLT in HES group at 12 and 24h were less than those in SEP group ,and there were significant differences （all P ＆lt; 0 .05） .Conclusion]Early use of HES 130/0 .4 can improve coagulation disorder in sepsis effectively ,and alleviate the further de-velopment of sepsis to some extent .