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中华卫生应急电子杂志

中华卫生应急电子杂志 ›› 2021, Vol. 07 ›› Issue (01) : 8 -12. doi: 10.3877/cma.j.issn.2095-9133.2021.01.002

所属专题： 文献；

论著

新西兰兔创伤性凝血功能障碍模型的建立及评价
吴杨1, 易石坚1,†(), 李兰兰2, 梁乾坤1, 吴松燕3, 肖月3   
  1. 1. 518055　广东深圳，深圳大学总医院普通外科
    2. 518103　广东深圳，深圳市福永人民医院感控科
    3. 518055　广东深圳，深圳大学总医院门诊部
  • 收稿日期:2020-01-07 出版日期:2021-02-18
  • 通信作者: 易石坚
  • 基金资助:
    深圳市科技计划项目（基础研究）(JCYJ20170818102312352)

Establishment and evaluation of traumatic coagulation dysfunction model in New Zealand rabbits

Yang Wu1, Shijian Yi1,†(), Lanlan Li2, Qiankun Liang1, Songyan Wu3, yue Xiao3   

  1. 1. Department of General Surgery, Shenzhen University General Hospital, Shenzhen 518055, China
    2. Department of Outpatient, Shenzhen University General Hospital, Shenzhen 518055, China
    3. Department of Noscocomial Infection Control, Shenzhen Fuyong People’s Hospital, Shenzhen 518103, China
  • Received:2020-01-07 Published:2021-02-18
  • Corresponding author: Shijian Yi
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吴杨, 易石坚, 李兰兰, 梁乾坤, 吴松燕, 肖月. 新西兰兔创伤性凝血功能障碍模型的建立及评价[J/OL]. 中华卫生应急电子杂志, 2021, 07(01): 8-12.

Yang Wu, Shijian Yi, Lanlan Li, Qiankun Liang, Songyan Wu, yue Xiao. Establishment and evaluation of traumatic coagulation dysfunction model in New Zealand rabbits[J/OL]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2021, 07(01): 8-12.

目的

建立新西兰兔创伤性凝血功能障碍模型，探讨创伤失血性休克引起的凝血功能障碍的病理变化，对该模型做出合理评价，为后期研究不同种类液体复苏策略提供可靠的动物实验方法。

方法

以30只新西兰兔为实验对象，麻醉成功后建立创伤性凝血功能障碍模型，分别于建模前15 min、建模后15min、30 min、1 h抽血检测并记录血常规、动脉血气指标、凝血功能、凝血因子、体温、心率等指标观察动物成活率。

结果

1 h存活率为100%。实验动物pH值、氧分压(PO2) 、剩余碱(BE)值在休克后30 min开始下降，1 h出现大幅度下降，心率、K＋浓度在建模后30 min升高，1 h显著升高，与建模前比较差异有统计学意义(P<0.05)；差异无统计学意义。红细胞计数(RBC)、血红蛋白(HGB)、红细胞比积(HCT)、血小板计数(PLT)、白细胞计数(WBC)在建模后30 min内变化差异无统计学意义，建模后1 h红细胞计数(RBC)、血红蛋白(HGB)、红细胞比积(HCT)、血小板计数(PLT)、白细胞计数(WBC)与建模前比较差异有统计学意义(P<0.05)。部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)均在建模后出现下降，与建模前比较差异有统计学意义(P<0.05)，凝血因子Ⅱ、Ⅶ、Ⅹ、Ⅸ、Ⅺ变化无明显统计学意义。

结论

本实验建立创伤性凝血功能障碍动物模型，为研究创伤性凝血障碍提供了简便、实用、稳定的模型，为后期探讨不同种类液体复苏策略选择打下了坚实的基础。

关键词: 创伤和损伤, 凝血功能障碍, 动物模型
Objective

To establish a New Zealand rabbit model of traumatic coagulation dysfunction, to explore the pathological changes of coagulation dysfunction caused by traumatic hemorrhagic shock and to make a reasonable evaluation of the model to provide a reliable animal experiment method for later research on different types of fluid resuscitation strategies.

Methods

Thirty New Zealand rabbits were used as experimental subjects to establish animal experimental models after successful anesthesia. Blood was drawn 15 minutes before modeling, 15 minutes, 30 minutes and 1 hour after modeling to detect and record blood routine, arterial blood gas indicators, coagulation function, coagulation factors, body temperature, heart rate and other indicators.

Results

Finally, 30 New Zealand rabbits were included in the experiment, and the 1-hour survival rate was 100%. The pH value, partial pressure of oxygen (PO2), and residual alkali (BE) values of the experimental animals began to decrease at 30 min after shock, and a significant decrease occurred at 1 h. Heart rate and K+ concentration increased at 30 min after modeling, and significantly increased at 1 h. There was a significant difference before modeling (P<0.05); body temperature kept no changes. The red blood cell count (RBC), hemoglobin (HGB), hematocrit (HCT), platelet count (PLT), and white blood cell count (WBC) showed no significant difference within 30 minutes after modeling. Red blood cell count (RBC), 1h after modeling Hemoglobin (HGB), hematocrit (HCT), platelet count (PLT), white blood cell count (WBC) were significantly different from those before modeling (P<0.05). Partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), and fibrinogen (FIB) all decreased after modeling, which were significantly different from that before modeling (P<0.05), and the changes of coagulation factors Ⅱ, Ⅶ, Ⅹ, Ⅸ, and Ⅺ had no significant statistical significance.

Conclusion

This study proves the feasibility of this experimental method to establish an animal model of traumatic coagulopathy, providing a simple, practical and stable model for the study of traumatic coagulopathy, which lays a solid foundation for the later discussion of different types of fluid resuscitation strategies.

Key words: Wounds and injuries, Coagulation dysfunction, Animal model
表1 新西兰兔体温、心率、pH值、PO2、K＋浓度、BE建模前后指标变化检验(±s，n＝30)
时间 心率(次/分) 体温(℃) PH值 PO2(mmHg) K＋浓度(mmol/L) BE(mmol/L)
建模前15 min 185±4.2 38.4±0.3 7.43±0.07 98.9±8.14 4.51±0.36 -6.83±4.97
建模后15 min 189±5.1 38.1±0.8 7.39±0.04 98.1±7.42 4.75±0.12 -6.98±4.28
建模后30 min 211±7.3 37.8±0.6 7.37±0.09 93.2±6.88 5.22±0.81 -9.25±5.22
建模后1 h 209±5.9 37.4±0.6 7.36±0.09 90.2±6.94 5.31±0.17 -11.21±3.88
F值 24.35 1.21 3.78 10.52 6.34 32.51
P值 <0.05 >0.05 <0.05 <0.05 <0.05 <0.05
表2 新西兰兔RBC、HGB、HCT、PLT、WBC建模前后指标变化检验(±s，n＝30)
时间 RBC(×1012/L) WBC(×109/L) PLT(×109/L) HGB(g/L) HCT(%)
建模前15 min 5.48±0.47 9.52±1.91 363.75±80.13 113.41±10.56 35.86±1.27
建模后15 min 5.18±0.71 9.22±2.94 323.91±65.11 108.11±13.27 29.96±2.01
建模后30 min 4.34±0.25 10.12±3.11 271.89±74.55 86.23±11.26 28.21±1.55
建模后1 h 3.18±0.19 11.48±2.45 221.88±60.51 64.91±10.22 38.24±2.21
F值 22.34 1.65 8.76 32.22 23.65
P值 <0.05 >0.05 <0.05 <0.05 <0.05
表3 新西兰兔PT、TT、APTT、FIB、凝血因子Ⅱ、Ⅶ、Ⅹ、Ⅸ、Ⅺ建模前后指标变化检验结果比较(±s，n＝30)
时间 PT(s) TT(s) APTT(s) FIB (g/L) Ⅱ因子(%) Ⅶ因子(%) Ⅹ因子(%) Ⅸ因子(%) Ⅺ因子(%)
建模前15 min 10.70±1.89 18.4±2.1 18.74±1.05 2.34±0.26 93.74±31.05 67.74±12.46 37.74±11.08 152.14±42.29 57.74±19.68
建模后15 min 11.23±1.54 18.6±1.9 22.12±2.97 2.14±0.44 94.38±21.34 61.33±14.54 32.56±13.53 137.22±52.08 50.30±16.21
建模后30 min 12.31±1.08 22.7±4.2 31.67±4.19 1.95±0.31 89.44±38.78 65.12±11.96 33.21±16.32 143.89±64.21 53.21±17.54
建模后1 h 22.76±1.49 32.1±6.4 38.28±1.95 1.54±0.76 92.51±30.01 69.31`±13.79 36.84±19.48 150.31±32.88 55.72±18.76
F值 10.53 5.45 9.26 8.63 2.08 1.89 1.66 1.53 1.87
P值 <0.05 <0.05 <0.05 <0.05 >0.05 >0.05 >0.05 >0.05 >0.05
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