蝮蛇抗栓酶治疗Budd－Chiari综合征的机理

• 作 者: 江学良 崔慧斐 孙成刚 张建忠 董兆禄
• 机 构: 济南军区总医院消化科,山东医科大学,山东省肥城矿务局医院
• 出 处: 新消化病学杂志
• 发表日期: 1996年12期
• 关键词: 蝮蛇抗栓酶 血小板粘附 肝静脉血栓形成 腹蛇／治疗作用 血粘度 红细胞压积 血栓素 双缩脲法 Chiari 前列腺素类

目的研究蝮蛇抗栓酶（ＳＶＡＴＥ）治疗Ｂｕｄｄ＿Ｃｈｉａｒｉ综合征（ＢＣＳ）的疗效机理。方法ＢＣＳ重症患者３０例，应用ＳＶＡＴＥ治疗（０７５Ｕ／ｄ×１４－２１ｄ）前后测定血浆中ＰＧＩ２，ＴＸＡ２的含量（ＲＩＡ法），血粘度，红细胞压积（Ｗｉｎｔｒｏｂｅ法），纤维蛋白原含量（双缩脲法），体外血栓形成的长度、重量及血小板粘附率，并与２０例健康人对照。结果ＢＣＳ患者血粘度比（５１８％±０７７％ｖｓ４８１％±０３９％）、红细胞压积（４９４％±４５％ｖｓ４５１％±３４％）、体外血栓形成的长度（２３６ｃｍ±０６２ｃｍｖｓ１７０ｃｍ±０４１ｃｍ）、湿重（６８２ｍｇ±１３２ｍｇｖｓ５１１ｍｇ±１２２ｍｇ）、干重（２３２ｍｇ±５１ｍｇｖｓ１６７ｍｇ±４１ｍｇ）及血小板粘附率（４１３％±１２４％ｖｓ３４１％±９１％）明显高于正常人（Ｐ＜００５）。应用ＳＶＡＴＥ治疗２－３周后，上述各项指标均有改善（Ｐ＜００５）。ＢＣＳ患者血浆中ＴＸＡ２的含量（５３４１７ｎｇ／Ｌ±８１３４ｎｇ／Ｌｖｓ３４０１２ｎｇ／Ｌ±４０３９ｎｇ／Ｌ）及ＴＸＡ２／ＰＧＩ２比值（２４９±７５ｖｓ１５?

Objective To study the curative effect of SVATE on Budd_Chiari syndrome (BCS). Methods Thirty patients with severe BCS were treated with SVATE (075 U/d×14-21d) before and after treatment to determine plasma PGI2 and TXA2 levels (RIA method), blood viscosity, hematocrit (Wintrobe method), and fibrinogen content. (Biuret method), the length, weight, and platelet adhesion rate of extracorporeal thrombosis were compared with 20 healthy subjects. Results Blood viscosity ratio of BCS patients (518%±077% vs481%±039%) and hematocrit (494%±45% vs451%±34%) Length of extracorporeal thrombosis (236cm±062cm vs170cm±041cm), wet weight (682mg±132mg vs511mg±122mg), dry weight (232mg±51mgvs16) 7mg±41mg) and platelet adhesion rate (413%±124% vs341%±91%) were significantly higher than normal subjects (P<005). After treatment with SVATE for 2-3 weeks, all the above indicators improved (P<005). The plasma levels of TXA2 in patients with BCS (53417ng/L±8134ng/L vs.34012ng/L±4039ng/L) and TXA2/PGI2 ratio (249±75 vs15)