摘要
目的观察利伐沙班、氯吡格雷、依诺肝素钠等几种抗凝药物预防损伤后小动脉血栓形成的效果。方法损伤大鼠股动脉制作血栓模型,将大鼠分5组:a组:术前至术后1周,每日1次依诺肝素钠注射;b组:术前至术后1周,每日1次利伐沙班灌胃;c组:术前至术后1周,每日1次氯吡格雷灌胃;d组(肝素对照组):术前至术后1周,每日2次注射肝素;e组(空白对照组):术前至术后1周,每日1次注射等容量生理盐水。术后2h及1周检查吻合口通畅情况,术后1周测定大鼠血浆活化的部分凝血活酶时间(APTT)和凝血酶原时间(PT)。结果 a、b、c、d组各时间点的吻合口通畅率比e组均有非常显著性的提高,但其中c组较低,差异均有统计学意义,a、b、d组基本相同,差异无统计学意义;a组切口皮下出现张力性血肿1处,d组切口皮下出现张力性血肿4处,其他组未出现血肿;d组术后1周APTT、PT较其它4组延长,与空白对照组及c组相比差异性有显著性意义(P<0·05),a、b、c三组间及其与对照组相比APTT、PT差异无统计学意义(P>0·05)。结论利伐沙班、氯吡格雷、依诺肝素钠等抗凝药物在不增加出血倾向的前提下能预防损伤小动脉吻合口的血栓形成,氯吡格雷相对利伐沙班、依诺肝素抗凝效果较差,其中利伐沙班仅须每日1次口服给药,使用方便,依从性、耐受性更好,可作为显微外科抗凝用药的理想选择。
Objective To observe the anticoagulation effects of rivaroxaban, clopidogrel, enoxaparin sodium for preventing thrombosis in injured arterioles. Methods The femoral arteries of rats were injured to make thrombosis model, The rats were divided into six groups, and measures were taken as follows from pre-operation to one week after operation： group A, enoxaparin sodium was injected q.d. ; group B, rivaroxaban was given by intragastric administration q. d. ; group C, clopidogrel was given by intragastric administration q. d; group D, both rivaroxaban and clopidogrel were given by intragastric administration q. d; group E was heparin control group and group F was blank control group, which were injected heparin b. i, d. and saline q.d. respectively. The anastomotic potency was examed at two hours after operation and one week later, Activated partial thromboplastin time （APYI＇） and prothrombin time （PT） were both tested one week alter operation. Results The patency rates of group A, B, C, D at each time point increased significandy comparing with group F. Also, the potency rate in group C was much lower than that in group D, and this difference was statistically significant. Tension hematoma was found at the incision site in group A （one case）, group D （three cases）, and group E （four cases）. APTr and PT were prolonged in group D and group E. which was significantly different （P 〈 0. 05 ）. The other groups had no significant difference in APTF and PT （P 〉 0.05）. Conclusions Rivaroxaban, clopidogrel and enoxaparin sodium can prevent thrombosis at the anastomosis of arteriole without increasing the risk of hemorrhage, especially combining rivaroxaban and clopidogrel. Combination of these two drugs only needs oral administration q. d. , which is convenient and durable for patients, and would be an ideal choice for microsurgery.
出处
《中华关节外科杂志（电子版）》
CAS
2011年第2期31-35,共5页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
宁波市科技计划项目(200901c4010020)
关键词
依诺肝素
抗凝药
小动脉
血栓形成
动物
实验
Enoxaparin
Anticoagulants
Arterioles
Thrombosis
Animals, laboratory
