摘要
目的探讨大黄防治危重病患者凝血功能障碍的机制。方法70例无凝血功能障碍的危重病患者随机分为2组,对照组35例给予常规抗炎和脏器功能监测治疗,治疗组35例加用生大黄粉60g/d配置溶液后分3次鼻饲。分别检测2组患者治疗前、治疗后1、3、7d的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、血小板计数(ALT);测定2组患者血浆中肿瘤坏死因子(TNFα)、白细胞介素-6(IL-6)含量,观察血浆中vWF含量;统计2组患者弥漫性血管内凝血(DIC)发生率、多器官功能不全综合征(MODS)的发生率、死亡率,并进行统计学分析。结果治疗后,治疗组7d的检测指标与对照组比较有显著差异,2组患者DIC发生率、MODS的发生率、死亡率统计比较,差异有统计学意义。结论大黄可以通过对血管内皮细胞的保护作用抑制vWF升高,抑制炎性细胞因子过度增生,从而减轻凝血系统过度激活,防治DIC、MODS的发生、降低MODS死亡率。
[ Objective] To investigate the mechanism of rhubarb on prevention of blood coagulation dysfunction in critical patients. [ Methods ] 70 critical patients with non-coagulation dysfunction were randomly divided into two groups, 35 cases of the control group were given conventional anti-inflammatory and organ function monitoring treatment, the treatment group with 35 cases was treated with rhubarb powder 60g/day at 3 times on the basis of regular treatment, which was given by nasal feeding after dissolved. The pro- thrombin time {PT）, activated partial thromboplastin time （ APTT）, fibrinogen {Fig}, platelet count { Pit） before treatment, after treatment 1,3 and 7 days were detected. The plasma tumor necrosis factor { TNFa } and interleukin6 { IL-6 ） content were tested, and the plasma vWF was observed. The mortality, incidence of DIC and MODS of two groups were counted and analyzed statistically. [ Results] After the treatment, there was significant difference in 7 days indicator between the treatment group and the control group. The difference in the mortality, incidence of DIC and MODS between two groups was significant. [ Conclusion] Rhubarb can inhibit the increasing of vWF and excessive hyperplasia of inflammatory cytokines by protecting vascular endothelial ceils, which helps to reduce the coagulation system activation, prevent DIC and MODS, and decrease the mortality of MODS.
出处
《职业与健康》
CAS
2009年第22期2450-2452,共3页
Occupation and Health
关键词
大黄
危重病
凝血功能
Rhubarb
Critically ill
Blood coagulation function
