慢性胆道感染对兔门静脉系统凝血环境的影响
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张诚华, Email: zch180@263.com

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南京军区重点课题资助项目(10MB018)。


Influence of chronic biliary infection on coagulation status in portal vein system in rabbits
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    目的:观察兔慢性胆道感染后门静脉血与外周血凝血功能的改变。方法:24只健康成年新西兰兔随机均分为模型组和对照组,家兔均行经皮胆囊管置管。模型组兔经留置管注入大肠杆菌,每周1次,连续3周;对照组则以同样方式注射生理盐水。两组兔于末次注射后3 d取耳缘静脉及门静脉血,并取近第一肝门处肝组织样本,检测两处血液样本的凝血功能、D-二聚体(DD)水平,观察门静脉病理变化。结果:模型组动物造模后进食量明显减小,肛温升高,体质量下降,而对照组一般情况较造模前无明显变化。与对照组比较,模型组耳缘静脉血DD明显升高(P<0.01),但凝血时间(CT),凝血酶原时间(PT),活化部分凝血活酶时间(APTT)均无明显改变(均P>0.05),而门静脉血中除DD明显升高外,CT,PT,APTT均明显缩短(均P<0.01)。病理学检查可发现模型组门静脉微小血栓形成,而对照组未见。结论:慢性胆道感染可以导致门静脉系统局部高凝状态并微血栓形成,外周血DD的检测对诊断胆道感染并发门静脉血栓有一定的意义。

    Abstract:

    Objective: To observe the changes of coagulation status in portal vein and peripheral blood in rabbits with chronic biliary infection. Methods: Twenty-four healthy adult New Zealand rabbits were equally randomized into model group and control group. All rabbits underwent indwelling cystic duct catheterization, and the rabbits in model group were subjected to E. Coli solution injection via the indwelling catheter, weekly for 3 weeks, while those in control group received normal saline instead in the same fashion. On the third day after the last injection, blood samples were taken from the marginal ear vein and portal vein of the rabbits in both groups, and liver tissues adjacent to the first porta were harvested; the blood clotting functions and D-dimer (DD) levels in the blood samples from the two sites were measured, and the pathological alteration in the portal veins were observed. Results: After model creation, rabbits in model group presented with decreased food intake, increased rectal temperature and reduced body weight, while these general conditions of those in control group showed no obvious change. Compared with control group, the blood from the marginal ear vein of model group showed that the DD level was significantly increased (P<0.01), but the indexes that included coagulation time (CT), prothrombin time (PT) and activated partial thromboplaslin time (APTT) were not significantly changed (all P>0.05), while the blood from the portal vein of model group showed significantly increased DD level, but the CT, PT and APTT levels were all significantly shortened (all P<0.01). The pathological findings showed that there was small thrombus formation in portal vein in model group, which was not noted in control group. Conclusion: Chronic biliary tract infection can result in local hypercoagulation status and microthrombosis in portal venous system, and detection of the peripheral blood DD level may have certain significance for diagnosis of biliary infection with portal vein thrombosis.

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何谦|张少波|祝峰|刘朝辉|潘建生|张诚华.慢性胆道感染对兔门静脉系统凝血环境的影响[J].中国普通外科杂志,2013,22(8):1038-1042.
DOI:10.7659/j. issn.1005-6947.2013.08.017

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  • 收稿日期:2013-04-11
  • 最后修改日期:2013-08-02
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  • 在线发布日期: 2013-08-15