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Archive > Volume 10 Issue 2 > 2018,10(2):190-197. DOI:10.1016/j.chmed.2018.03.011 Prev Next

疏血通與阿司匹林合用能夠改善腦缺血再灌注損傷后凝血纖溶系統(tǒng)

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Protection of Shuxuetong combined with aspirin against cerebral ischemia/reperfusion injury through ameliorating coagulation and fibrinolysis system

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    摘要:
    目的：觀察疏血通(SXT)與阿司匹林合用對(duì)腦缺血再灌注損傷大鼠凝血及纖溶系統(tǒng)的影響。 方法：選用經(jīng)典的線栓法制備大鼠局灶性腦缺血再灌注損傷模型。將50只雄性SD大鼠隨機(jī)分為假手術(shù)組、腦中動(dòng)脈栓塞（MCAO/R）模型組、阿司匹林(10 mg/kg)組、疏血通(0.6 ml/kg)組、疏血通(0.6 mg/kg)+阿司匹林(10 mg/kg)組。按照Longa的5級(jí)評(píng)分方法進(jìn)行神經(jīng)功能缺損評(píng)分；干濕重法測(cè)定腦組織含水量；四氮唑紅（TTC）染色測(cè)定腦梗塞體積；腹主動(dòng)脈取血檢測(cè)血小板聚集率（MPAR）、凝血四項(xiàng)并用酶聯(lián)免疫法檢測(cè)大鼠血漿中血小板CD61、CD62p、 6-酮前列腺素F1α(6-keto-PGF1α)、抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚體(D-dimer)、纖溶酶原激活物抑制劑-1(PAI-1)、組織因子 (TF)、組織型纖溶酶原激活物(t-PA)、血小板血栓烷素B2 (TXB2)、血管性血友病因子（vWF）的含量。 結(jié)果：疏血通與阿司匹林合用能夠改善MCAO/R誘導(dǎo)大鼠神經(jīng)功能缺損，減輕腦水腫，縮小腦梗死體積。與假手術(shù)組相比較纖維蛋白原（FIB）、6-PGF1α、AT-Ⅲ、t-PA均有顯著的下降；與模型組相比較，疏血通與阿司匹林合用組的上述指標(biāo)都有明顯上調(diào)。模型組的凝血酶原時(shí)間（PT）、活化部分凝血活酶時(shí)間（APTT）、凝血酶時(shí)間（TT）、CD61、CD62p、D-dimer、PAI-1、TF、TXB2和vWF與假手術(shù)組相比都有明顯上升；經(jīng)疏血通與阿司匹林處理組的上述指標(biāo)都有明顯下降。合用效果與單用藥比較，差異具有顯著性。與假手術(shù)組比較，MPAR顯著升高；阿司匹林治療后，MPAR顯著下調(diào)；疏血通與阿司匹林合用給藥組MPAR下調(diào)水平降低。 結(jié)論：疏血通與阿司匹林合用能抑制血小板活化，調(diào)節(jié)血小板最大聚集率，改善凝血功能和纖溶系統(tǒng)。

    Abstract:
    Objective To explore the influence of the combination of Shuxuetong (SXT) and aspirin on coagulation and fibrinolytic system of rats. Methods Suture method was applied to establish focal cerebral ischemia-reperfusion injury models in rats. A total of 50 SD rats were randomly divided into sham group, middle cerebral artery occlusion/reperfusion (MCAO/R) group, aspirin (10 mg/kg) group, SXT (0.6 mL/kg) group, and SXT (0.6 mg/kg) + aspirin (10 mg/kg) group. The neurological deficits were assessed according to Longa's grade 5 scoring method. The cerebral edema was detected by measuring the content of water in brain tissue. The volume of cerebral infarction was observed by 2,3,5-Triphenyltetrazolium chloride (TTC) staining. Blood plasma was collected by abdominal aortic method to test maximum platelet aggregation rate and four blood coagulation. CD61, CD62p, 6-keto prostaglandin F1α (6-keto-PGF1α), antithrombin III (AT-III), D-dimer, plasminogen activator inhibitor-1 (PAI-1), tissue factor (TF), tissue plasminogen activator (t-PA), platelet thromboxane B2 (TXB2), and von Willebrand factor (vWF) content in rat plasma were detected by ELISA. Results SXT combined with aspirin could improve the neurological deficits, alleviate cerebral edema, and decrease the cerebral infarct value. Compared with the sham operation group, fibrinogen (FIB), 6-PGF1α, AT-III, and t-PA in model group were significantly decreased; Compared with the model group, the above-mentioned indexes in SXT and aspirin treatment group were significantly increased. The prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), D-dimer, PAI-1, TF, TXB2, and vWF of the model group were significantly increased; the above-mentioned indexes in blood SXT + aspirin treated group were significantly decreased. There was a significant difference between the combined group and SXT group. The maximum concentration of plateletsin aspirin treated rats was significantly decreased, however, MPAR was reversed in SXT + aspirin treated group. Conclusion SXT combined with aspirin can effectively inhibit platelet activation, regulate the maximum concentration of platelets, and improve coagulation function and fibrinolysis system.

    關(guān)鍵詞:
    疏血通;凝血;纖溶系統(tǒng);阿司匹林

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