To investigate the mechanism of new therapy of 20AA compound amino acid injection plus high-dose vitamin B₆ on trauma-induced coagulapathy.

The male SD rats were randomly divided by random digits table. Rats in the experiment of animal model was divided into control group, model groups at different time points (4 h, 6 h, 12 h, 24 h, 48 h), a total of six groups, 10 in each group. Rats in the experiment of effect of new therapy were divided into normal group, control group, new therapy group, a total of 3 group, 8 in each group. Rats in the experiment of mechanism of new therapy were divided into normal group, sham group control group, new therapy group, then control group and new therapy group were divided into four sub-groups (4 h, 6 h, 12 h and 24 h) at different time points after injury, 3 in each group. The multiple trauma model of rat was establish by Using Feeney’s free fall epidural impact method, plus bilateral femoral fractures and bleeding. The new therapy group was infused with 20AA compound amino acid injection plus high dose of vitamin B₆ by jugular vein intubation. The control group was infused with same volume of saline injection. The specimens of rats were isolated and tested according to the time-points of experiments, respectively.

(1)The experiment of animal model: R value of TEG reaches its peak at 48 h, and the R value in model groups at 24 h and 48 h were statistically significant compared with control group (P<0.05). K value and Angle value changed little among different groups. There was no statistical significance comparing with the control group. MA value increased from 4 h after trauma, and reach the maximum at 48 h. There were significant difference between the 24 h, 48 h group and the control group (P<0.01). (2)The experiment of effect of new therapy: The R value of thrombelastography in the new therapy group (2.24±0.68) min was significantly lower than the value of the control group(3.21±0.30) min(P<0.05). The Angle value of thrombelastography in the new therapy group (81.98 ± 1.78)° was significantly higher than the value of the control group (79.54±2.13)°(P<0.05). In traditional coagulation test results, the prothrombin time (PT), activated partial clotting enzyme live time (APTT), thrombin time (TT) in the new therapy group were lower than the values in the control group, but fibrinogen (FIB) was higher than the one of the control group, but the differences were not statically significant. (3)The experiment of mechanism of new therapy: Compared with normal group, excepted for FⅪ and FⅩⅢ A subunit, the expression level of coagulation factor genes in control group and new therapy group was up-regulated significantly from 4 h after injury, but the expression level was down-regulated with time. Compared with control group, the expression level was higher in the new therapy group and the difference was statistically significant (P<0.05).

There was coagulation dysfunction at the early stage of trauma in the rat model of multiple trauma, which was consistent with clinical observation. The treatment of 20AA compound amino acid injection plus high dose of vitamin B₆ can significantly improve the coagulation function of multiple trauma model of rat, and the mechanism of the new therapy on trauma-induced coagulopathy may be mediated by enhancing the expression of the coagulation factor genes in the liver.