摘要
目的探讨青蒿琥酯对红细胞渗透脆性的影响及临床使用安全性。方法以不同浓度的青蒿琥酯与红细胞悬液孵育12 h,肉眼观察和用氰化高铁血红蛋白测定法检测溶血程度;红细胞渗透脆性试验检测药物处理后各组红细胞的最大脆性和最小脆性,再用氰化高铁血红蛋白法检测各组的最大脆性溶血情况。并用统计软件SPSS16.0对各组检测结果进行统计分析。结果肉眼未观察到不同浓度的青蒿琥酯处理组有明显溶血现象,方差分析显示各大组内用氰化高铁血红蛋白测定的不同组吸光度值差异无统计学意义(P>0.05);除低浓度的两处理组(青蒿琥酯的终浓度为12.5、6.25μg/mL)外,其余各处理组的最大脆性和最小脆性均高于正常人和对照组的渗透脆性,且最大脆性随药物浓度增加,肉眼观察和氰化高铁血红蛋白检测显示其溶血程度也增加;当青蒿琥酯浓度大于或等于25μg/mL时,各处理组的最大脆性的吸光度值逐渐增加,与对照组最大脆性的吸光度值相比差异有统计学意义(P<0.05);当青蒿琥酯浓度小于或等于12.5μg/mL时,各处理组的最大脆性的吸光度值增加不明显,与对照组比较差异无统计学意义(P>0.05)。结论目前临床使用的青蒿琥酯剂量相对比较安全,大剂量的青蒿琥酯虽然不能直接导致红细胞溶血,但可增加红细胞的渗透脆性,如需加大用药剂量应警惕血管内溶血的发生。
Objective To research the effect of artesunate on the osmotic fragility of red blood cells and the clinical using safety of artesunate.Methods Different concentrations of artesunate were incubated with red blood cells for 12 h,the levels of hemolysis were detecte by visual observation and hemiglobincyanide;the red blood cell osmotic fragility test was used to detected the maximum and minimum osmotic fragility of red blood cells in each group treated by different concentration of artesunate.The hemolysis status of maximum osmotic fragility in every group was detected by the hemiglobincyanide.The statistics software SPSS16.0 was applied to compare the results of different groups.Results No significant hemolysis of red blood cells incubated with artsunate was observed by eyes,there were no conspicuous differences among the optical density of every group treated by artsunate when analyzed by the ANOVA（P〈0.05）.Except two low concentration groups（the final concentration of artesunate was 12.5,6.25 μg/mL）,the maximum and minimum osmotic fragilities of red blood cells in the remaining groups were higher than those of normal or the control group.With the drug concentration of the maximum osmotic fragility increased,the degree of hemolysis of the maximum osmotic fragility also increased when detected by the visual observation or the hemiglobincyanide.When the concentration of artesunate ≥ 25 μg/mL,the optical density of maximum osmotic fragility increased gradually,there was significant difference（P〈0.05） between each drug treated group and the control group.But when the concentration of artesunate ≤12.5 μg/mL,there was no difference between the experimental group and the control one（P〈0.05）.Conclusion The current clinical dose of artesunate is relatively safe,though the high-dose of artesunate can not directly cause the hemolysis of red blood cells,but it can increase the osmotic fragility of RBC,the intravascular hemolysis must be vigilant when increasing dosage.
出处
《重庆医学》
CAS
CSCD
北大核心
2010年第21期2872-2874,2877,共4页
Chongqing medicine
基金
国家自然科学基金资助项目(90709010)
