摘要
本研究观测了57例严重烧伤病人(TBSA 61.2±22.1％)血浆TXB_2、6-酮-PGF_1α、血流动力指标、心肌酶谱、循环血小板聚集物比率(CPAR)、血小板计数和全血粘度的动态变化。结果发现,伤后1/2天,血浆TXB_2,6-酮-PGF_1α和TXB_2/6-酮-PGF_1α比值均急剧增高,然后逐渐降低,TXB_25天内均明显增高,6-酮-PGF_1α伤后第2天即降至对照水平,TXB_2/6-酮-PGF_1α比值3天内均明显增高。伤后1/2天,心功能各指标均降至最低值,以后逐渐回升,但每搏量(SV)和每搏指数(SVI)伤后5天内均明显低于正常水平。而外周阻力(SVR)伤后36h内明显增高。伤后1/2天,心肌酶谱CPK、LDH和GOT即明显增高,1～5天进一步增高。CPAR和血小板计数伤后早期则明显降低。以1/2天最低,相反全血粘度伤后1/2天达最高值,2天内均有较大幅度增高。这些结果表明,严重烧伤后血流动力学和流变学指标均有明显变化,同时TXA_2/PGI_2发生明显平衡失调,TXA_2/PGI_2比值失衡的程度与血流动力学和流变学的变化一致,而且TXA_2/PGI_2比值与SV、CO、SVR、CPAR、血小板计数和全血粘度均呈明显相关,表明TXA_2/PGI_2比值失衡在烧伤后血流动力学和流变学变化中起重要作用。
Fifty seven everely burnt patients were observed for 28 days postburn.The plasma thromboxane B2(TXB2),6-keto-PGF 1α and TXB2/6-keto-PGF1α ratiojumped to their peaks at 1/2 postburn day(PBD),then gradually declined.6-keto-PGF1α re- turned to the control level at 2 PBD.TXB2 was higher than the control even at 5 PBD, TXB2/6-ketoPGF1α ratio increased within 3 PBD. All the cardiac function parameters dropped to their valleys at 1/2 PBD,then gradually recovered,SV and SVI were markedly lower than normal within 5 PBD. SVR increased within 36 h PB. CPK, LDH,GOT showed elevation at 1/2 PBD and increased further at 1-5 PBD.Circulatory platelet aggregate ratio (CPAR) and platelet count decreased to the lowest point at 1/2 PBD, and showed a greater degree of decrease within 2 PBD. The findings suggested that changes of heniodynamics and hemorrheology, imbalance between TXA2 and PGI2 occurred at the early stage in severely burnt patients. The extent of the imbalance accorded with the severity of hemorrhagic and hemorrheological changes and closely correlated with SV,CO,SVR,CPAR,platelet count and blood viscosity, substantiating that the imbalance of TXA2 and PGI2 played important roles in the hemodynamic and hemorrheological changes in severely burnt patients.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
1990年第3期174-179,192,共7页
Journal of Third Military Medical University
关键词
烧伤
血栓素
前列腺素
血液动力学
bnrns/PP
hemodynamics/DE
thromboxanest prostaglandins
platelet aggregation
