Ⅷ因子或可预测危重症患儿导管相关性血栓：初步研究

Ⅷ因子或可预测危重症患儿导管相关性血栓：初步研究/FactorⅧmay predict catheter-related thrombosis in critically ill children：a preliminary study.Faustino EV,Li S,Silva CT, et al.Pediatr Crit Care Med,2015,16(6)：497-504.
　　关键词标记；血因子；重症监护病房；血小板；血栓弹性描记法；凝血因子
　　摘要
　　目的如果我们能识别发生中心静脉导管相关性血栓风险较高的危重症患儿,就可以针对性给予预防血栓的药物。本研究旨在确定Ⅷ因子活性或G值是否和危重症患儿导管相关性血栓有关。

AIM：The mechanism of tumor necrosis factor-alpha (TNF-α) induced pulmonary artery hypertension(PAH) in endotoxic shock (ES) is not clear. Cholecystokinin-octapeptide (CCK-8) had anti-ES and anti-PAH effects. The impact of CCK-8 on changes in vascular reactivity and endothelial ultrastructure induced by TNF-α was studied. The role of nitric oxide (NO) was preliminarily studied. METHODS：Rabbit pulmonary artery rings were divided into four groups: TNF-α, TNF-α+CCK-8, CCK-8 and Vehicle. The rings were incubated for 2 h, 7 h or 14 h. Relaxative responses to ACh(10-8-10-5 mol/L)， SNP (10-9-10-6 mol/L) and contractile responses to PE(10-8-10-5 mol/L) were generated seperately. The NOS activity of rings was detected and the ultrastructure of endothelium was observed in the groups that incubated for 7 h.RESULTS:The relaxative responses to ACh were not affected by TNF-α and CCK-8 after incubation for 2 h. TNF-α(7 h,14 h) significantly reduced ACh-induced endothelium-dependent relaxation response of pulmonary artery. CCK-8 reversed the effect. CCK-8 itself had no effect on responses of normal pulmonary artery. Contraction to PE and relaxation to SNP were unaffected by TNF-α, CCK-8. The NOS activity increased in the TNF-α and the TNF-α+CCK-8 groups. While no significant difference was obseved between the Vehicle and the CCK-8 groups. Endothelial injury in TNF-α group and alleviated changes in TNF-α+CCK-8 group were observed. CONCLUSION:TNF-α significantly inhibits endothelium-dependent relaxation, which be one of the mechanisms of PAH induced by TNF-α during ES. It was found for the first time that CCK-8 reversed TNF-α induced impairment of endothelium-dependent relaxation and alleviated structural injury of endothelium, which might be one of the mechanisms of anti-PAH effect by CCK-8 during ES. The effects of TNF-α and CCK-8 might be related to NO.

陈可冀治学学术思想临床经验暨清宫医药老年医学研究成就初步探讨(续)

主攻心血管疾病 兼及其它疑难病两书中,<医学选集>中收载他治疗心血管病及其它急危或顽难疾病的"基础实验研究和临床观察"文章,临床研究的<医案实录>一书收载他治疗心血管病及其它急危或顽难疾病翔实医案135则.