Comparative analysis of the hemostatic effect of systemic recombinant Factor VIIa and exogenous fibrin monomer in an experimental model of heparinization and posttraumatic blood loss

Vyacheslav M. Vdovin; Вдовин Вячеслав Михайлович; Vyacheslav M. Vdovin; Igor I. Shakhmatov; Шахматов Игорь Ильич; Igor I. Shakhmatov; Natalya A. Lycheva; Лычёва Наталья Александровна; Natalya A. Lycheva; Evgeniy А. Subbotin; Субботин Евгений Александрович; Evgeniy А. Subbotin; Andrey P. Momot; Момот Андрей Павлович; Andrey P. Momot

doi:10.17816/brmma635130

重组因子VIIa和外源性纤维蛋白单体系统的应用于肝素化和创伤后失血实验模型中的止血效果比较分析

作者: Vdovin V.M.¹, Shakhmatov I.I.¹, Lycheva N.A.¹, Subbotin E.А.¹, Momot A.P.¹^,2
隶属关系:
1. Altai State Medical University
2. National Medical Research Center of Hematology
期: 卷 26, 编号 4 (2024)
页面: 569-578
栏目: Original Study Article
URL: https://journals.rcsi.science/1682-7392/article/view/285205
DOI: https://doi.org/10.17816/brmma635130
ID: 285205

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详细

本文介绍了重组因子VIIa对肝素凝血病和创伤后出血模型系统的止血作用研究结果，并与使用外源性纤维蛋白单体进行了比较。在兔子模型中，通过在受伤前15分钟静脉注射一次剂量为150单位/kg的非分馏肝素再现凝血病。使用剂量为270μg/kg的重组因子VIIa或者剂量为0.25mg/kg的纤维蛋白单体作为系统的止血剂。用药1小时后，模拟标准肝损伤，随后评估伤口失血的性质。使用旋转血栓弹力仪和凝血图评估动物静脉血的凝血时间、α角、血块形成时间、最大血块硬度和第10 分钟时的血块密度；还测定了活化部分凝血活酶时间、凝血酶原时间、凝血酶时间和纤维蛋白原浓度。由于药物引起的凝血病，与对照组相比，观察到低凝血位移，并伴有严重失血（1.9倍，p = 0.028）和动物高死亡率（26.1％，p = 0.022）。预防性使用纤维蛋白单体或重组因子 VIIa可减少创伤后失血量（分别为5.4倍，p < 0.001和2.1倍，p = 0.009），从而降低死亡率。同时，根据止血系统指标和血栓弹性测定数据，采用这些药物并不能弥补明显的低凝状态。所获得的数据表明，这两种制剂都具有止血效果，而纤维蛋白单体的止血效果更为明显，这也为考虑在创伤相关出血中使用低剂量纤维蛋白单体的前景可能性做出额外贡献。纤维蛋白单体的作用机制需要进一步研究。由此可见，从血浆中提取的纤维蛋白原衍生物，即纤维蛋白单体，可以与已知的系统的止血剂一样，作为控制伤口失血的候选药物。

关键词

创伤后失血, 肝素, 重组因子VIIa, 纤维蛋白单体, 止血系统, 创伤性凝血病, 止血剂

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MD, Dr. Sci. (Medicine), professor, Altai Branch

俄罗斯联邦, Barnaul; Barnaul

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