肝硬化患者凝血功能检测的临床价值

目的分析和探讨肝硬化患者凝血功能检测的临床价值。方法选取广东省乐昌市中医院2013年1月—2014年1月收治的52例肝硬化患者(观察组),选取同时期在我院接受检查的52例健康人员(对照组),全部患者均进行凝血功能相关指标检查,包括纤维蛋白原(FIB)、凝血酶时间(TT)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)等指标,对检查结果进行分析。结果观察组患者纤维蛋白原水平明显低于对照组,凝血酶时间、活化部分凝血活酶时间及血浆凝血酶原时间较对照组显著延长,差异具有统计学意义(P0.05)。结论血浆凝血因子异常是加重肝硬化发展的主要原因之一,对肝硬化患者凝血功能进行检测,有利于早期发现和辅助诊断疾病,对预防和治疗肝硬化出血具有重要的意义,值得临床推广应用。     

血脂生化检验中采用分级检验方法的检验效果观察

目的研究并探讨在血脂生化检验中采用分级检验方法的检验效果。方法选取2014年1月—2016年12月期间温州医科大学检验学院、生命科学学院实验室收集的160份血液标本作为研究对象,采取数字随机分组法随机分为两组,每组80份血液标本,对照组血液标本采用传统拉网式检验方法进行检测,观察组血液标本采用分级检验方法进行检测,比较两组血液标本的血脂生化检验结果。结果两组血液标本经血脂生化检验后,其总胆固醇、甘油三酯、高密度脂蛋白胆固醇比较,差异均无统计学意义(P0.05),但观察组的低密度脂蛋白胆固醇、载脂蛋白A-1、载脂蛋白B与对照组比较具有统计学差异(P0.05);阳性率方面,两组总胆固醇、甘油三酯、高密度脂蛋白胆固醇的阳性率比较无统计学差异(P0.05),而观察组低密度脂蛋白胆固醇、载脂蛋白A-1、载脂蛋白B的阳性率均高于对照组(P0.05)。结论在血脂生化检验中采用分级检验方法可有效提高血脂异常的检出率,有利于提高血脂生化检验的准确性。     

肝素抗凝血浆用于急诊生化检验的可行性探析

目的探讨在临床急诊生化检验过程中,肝素抗凝血浆应用效果和可行性情况。方法选取中国人民解放军第5702厂职工医院2014年2月—2015年3月进行临床试验患者70例,所有患者血液样本收集量相同,且分成两支,一支有抗凝剂,一支无,选择专业智能生化分析器进行临床测定和检验,检验相关急诊生化项目,研究分析急诊生化检验结果。结果经过急诊生化检验发现,在血浆和血清相关离子以及二氧化碳和尿素上,70例患者之间不存在差异性,患者血清钾元素含量明显高于血浆钾元素含量,差异存在统计学意义(P0.05),且在葡萄糖含量上,患者血浆明显高于患者血清,差异存在统计学意义(P0.05)。结论肝素抗凝血浆用于急诊生化检验可行性较高,肝素抗凝可不经过血液凝固实现标本分离目标,还可抑制血溶产生,避免放置误差等问题出现,因此肝素抗凝血浆在急诊生化检验当中应用效果比较显著。     

肝素抗凝血浆与血清中微量元素测定的对比分析

目的研究肝素抗凝血浆代替血清进行微量元素测定的可行性。方法选择2014年6月在汉川市人民医院接受生化检验的272例患者,采用Beckman DXC800型全自动生化分析仪,同时检测患者的肝素抗血浆和血清中锌(Zn)、铁(Fe)、铜(Cu)3种微量元素的浓度。结果肝素抗凝血浆锌、铁与血清中的锌、铁离子浓度比较无显著差异,差异无统计学意义(P0.05);血浆中铜离子的浓度明显低于血清中铜离子的检测值,差异有统计学意义(P0.05),但通过回归方程可以校正。结论肝素抗凝检测方法能够有效避开血液的凝固过程,在短时间内分离标本并检测,从而减少放置误差。但肝素抗凝血浆铜的检验还应进行回归校正。     

微流控电阻抗检测系统构建及其应用

凝血时间检测主要用于凝血障碍性疾病的初步诊断、抗凝药物的监测以及外科手术前的评估,是医生对患者自身凝血功能进行评价的一项重要指标。本文应用微流控电阻抗技术,提出了一种基于叉指电极的微流体凝血时间检测方法。使用软刻蚀方式制作微流控芯片,将固化后带有微通道的聚二甲基硅氧烷(PDMS)与带有刻蚀电极的导电玻璃键合,搭建微流控电阻抗检测系统。本实验通过对血浆活化部分凝血活酶时间(APTT)的检测,得出血液凝固过程中阻抗值的变化曲线,引入微积分概念,确定血液凝固时间。     

血液透析联合血液灌流治疗急性肾功能衰竭的临床效果分析

目的分析急性肾功能衰竭采取血液透析联合血液灌流治疗的临床效果。方法选取2010年1月—2015年1月期间惠州市中医医院收治的24例急性肾功能衰竭患者作为研究对象,按治疗方法的不同将本组患者分为两组,对照组12例患者接受单纯血液透析治疗,观察组12例患者接受血液透析联合血液灌流治疗,治疗2个月后,对两组患者的临床指标及临床效果进行统计对比。结果观察组治疗后CRP、Cr、BUN、MMS指标优于对照组,差异有统计学意义(P0.05);观察组治疗有效率为91.67%(11/12),高于对照组75.00%(9/12),差异有统计学意义(P0.05)。结论对急性肾功能衰竭患者的治疗,采取血液透析联合血液灌流治疗的临床效果显著,促进患者康复,在临床中具有良好的应用价值。     

灯盏花素在断指再植术后的应用效果观察

目的研究在断指再植术后患者中使用灯盏花素对其并发症的防治效果以及影响再植成功率的情况。方法随机抽取兴宁市中医医院收治的30例断指再植患者,其中共有51根断指,以患者治疗时间作为标准,将其分为两组,所有患者都进行常规治疗,比如抗炎以及照射保温等,在此基础上15例观察组患者使用灯盏花素,对比两组患者治疗前后的凝血功能情况,血管危象发生率以及断指再植成活率。结果两组患者治疗后凝血功能均优于治疗前,且前后差异相比统计学意义显著(P0.05),并且两组患者间血管危象发生率以及断指再植成活率的差异显著(P0.05)。结论在断指再植术患者中,使用灯盏花素进行术后治疗,能够提高断指再植成功率,并且减少并发症的发生。灯盏花素具有抗凝、消炎以及扩张血管的效果,因此值得广泛使用。     

肺康复联合无创通气对慢阻肺急性加重患者生活质量的影响

目的观察肺康复治疗在无创通气基础上对慢阻肺急性加重期患者肺功能指标、运动耐力、生活质量的影响。方法选择2014年10月—2016年10月于广东医科大学附属厚街医院住院的71例慢阻肺急性加重期患者作为研究对象,随机分为两组,对照组28例,观察组43例,对照组给予有效抗感染、吸入糖皮质激素+长效β2受体激动剂(ICS/LABA)及氧疗,无创辅助通气,观察组在对照组基础上给予肺康复治疗,比较两者患者在肺功能指标、运动耐力、生活质量的变化。结果 (1)两组患者治疗前肺功能指标(FEV1、FEV1/FVC(%)、FEV1%Pred(%))6MWD、CAT评分差异无统计学意义。(2)两组患者治疗后观察组FEV1高于对照组,但差异无统计学意义(P0.05)。但治疗后第7天FEV1、FEV1/FVC(%)、FEV1%Pred(%)观察组高于对照组,差异有统计学意义;两组患者治疗后较治疗前6 min步行距离(6 MWD)明显升高,差异有统计学意义(P0.05);CAT评分明显下降,差异有统计学意义(P0.05)。(3)治疗后观察组6 MWD对照组,差异有统计学意义(P0.05);治疗后观察组CAT评分对照组,差异有统计学意义(P0.05),结论肺康复治疗联合无创通气能够明显改善COPD急性加重期患者运动耐力及生活质量,但肺通气功能指标FEV1无明显优于单用无创通气治疗。     

血液检验在贫血鉴别诊断中的作用研究

目的分析研究在贫血的鉴别诊断中血液检验所起到的作用。方法选取杭州市拱墅区米市巷街道社区卫生服务中心2012年8月-2014年4月经检验的贫血患者60例,作为观察组,其中30例为溶血性贫血患者,作为观察组1,另30例为缺铁性贫血患者,作为观察组2,再选取30例正常人作为对照组,均对其血细胞进行检测,观察3组患者血液中的RBC、MCV、Hb、MCH、RDW指标的差异,以及观察组中两组的灵敏度,特异性和符合率的差异。结果观察组1中RBC指标低于对照组,观察组2中Hb指标明显低于观察组1和对照组,对照组中MCH明显高于观察组1和观察组2,组间对比差异具有统计学意义(P<0.05)。观察组1与观察组2灵敏度、特异度和符合率的差异不具有统计学意义(P>0.05)。结论血液检验在贫血类型的鉴别诊断中,发挥重要的作用,具有一定的临床价值。     

儿童全血微量元素水平与反复呼吸道感染的关系分析

目的探讨儿童全血微量元素水平与反复呼吸道感染的关系。方法将100例反复呼吸道感染患儿设为观察组,将同期100例健康儿童设为对照组,比较两组血内微量元素的变化。结果1 0~2岁儿童,观察组体内的铁、锌、铜含量明显低于对照组,但铅含量明显高于对照组,组间差异具有统计学意义(P0.05);2 3~12岁儿童,观察组体内的铁、锌含量明显低于对照组,组间差异具有统计学意义(P0.05)。结论儿童血微量元素缺乏与反复呼吸道感染的的相关性较大,幼儿表现尤为明显。     

Effects of Tao‐Hong‐Si‐Wu decoction on acute blood stasis in rats based on a LC‐Q/TOF‐MS metabolomics and network approach

A novel approach using metabolomics coupled with a metabolic network was used to investigate the effects of Tao‐Hong‐Si‐Wu decoction (THSWD) on the rat model of acute blood stasis syndrome. Acute blood stasis syndrome was induced by placing the rats in ice‐cold water following two injections with epinephrine. The hemorheological indicators [whole blood viscosity (WBV) and plasma viscosity (PV)] and the blood coagulation indicators [thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB)] were detected. The nonparametric univariate method and multivariate statistical analysis were performed for determining the potential biomarkers. A correlation map was structured between biochemical indicators and hub metabolites to explain the effects mechanism of THSWD. After the administration of THSWD, the levels of WBV, PV, TT, APTT and FIB returned to levels observed in the control group. According to metabolomics coupled with metabolic network analysis, the intervention of THSWD in rats with acute blood stasis syndrome induced substantial and characteristic changes in their metabolic profiles. Fifteen metabolites were screened, which mainly involved 10 pathways and five hub metabolites, namely, l ‐glutamate, l ‐phenylalanine, N‐acylsphingosine, arachidonic acid and phosphatidate. The biochemical indicators and hub metabolites could be adjusted to close to normal levels by THSWD. Therefore, combining metabolomics and metabolic network helped to evaluate the effects of THSWD on acute blood stasis.     

Effects of rutin and hesperidin and their Al(III) and Cu(II) complexes on in vitro plasma coagulation assays

Two flavonoids, rutin and hesperidin, were investigated in vitro for anticoagulant activity through coagulation tests: activated partial thromboplastin time (aPTT), prothrombin time (PT) and thrombin time (TT). Only an ethanolic solution of rutin at the concentration of 830 μM prolonged aPTT, while TT and PT were unaffected. In order to evaluate whether the prolongation of aPTT was due to the decrease of coagulation factors, the experiment with deficient plasma was performed, showing the effects on factors VIII and IX. Since pharmacological activity of flavonoids is believed to increase when they are coordinated with metal ions, complexes of these flavonoids with Al(III) and Cu(II) ions were also tested. The results showed that complexes significantly prolonged aPTT and had no effects on PT and TT. Assay with deficient plasma (plasma having the investigated factor at less then 1%) revealed that complexes could bind to the coagulation factors, what may lead to a non-specific inhibition and aPTT prolongation. An effort was made to correlate stability of complexes with their anticoagulant properties.     

Evaluation of anticoagulant activity of two algal polysaccharides

Marine algae are important sources of phycocolloids like agar, carrageenans and alginates used in industrial applications. Algal polysaccharides have emerged as an important class of bioactive products showing interesting properties. The aim of our study was to evaluate the potential uses as anticoagulant drugs of algal sulphate polysaccharides extracted from Ulva fasciata (Chlorophyta) and Agardhiella subulata (Rhodophyta) collected in Ganzirri Lake (Cape Peloro Lagoon, north-eastern Sicily, Italy). Toxicity of algal extracts through trypan blue test and anticoagulant action measured by activated partial thromboplastin time (APTT), prothrombin time (PT) test has been evaluated. Algal extracts showed to prolong the PT and APTT during the coagulation cascade and to avoid the blood coagulation of samples. Furthermore, the algal extracts lack toxic effects towards cellular metabolism and their productions are relatively at low cost. This permits to consider the algae as the biological source of the future.     

Dual-functional composite with anticoagulant and antibacterial properties based on heparinized silk fibroin and chitosan

Heparinized biomaterials exhibit great anticoagulant properties. However, they promote proliferation of Staphylococcus aureus (S. aureus) and therefore cause infection within the bloodstream upon implantation in vivo. In the present study, an interesting dual-functional composite with anticoagulant and antibacterial properties based on heparinized silk fibroin and chitosan was synthesized. First, heparin was grafted onto the silk fibroin by covalent immobilization with N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide (EDC) and N-hydroxysuccinimide (NHS). All data gathered from Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and elemental analysis (EA) indicated that the heparin was successfully immobilized onto the silk fibroin. The dual-functional composite of heparinized silk fibroin and chitosan was then fabricated by a blending method. The anticoagulant activity of the heparinized materials was evaluated using the prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT). The results showed that both heparinized silk fibroin and the composite material exhibited better hemocompatibility in comparison with single silk fibroin or chitosan. The antibacterial property of the materials was investigated by the pour-plate method. Results further suggested that the composite antibacterial property with respect to S. aureus was significantly enhanced. The dual-functionality of the composite material may supply a potential choice in blood contact devices.     

水溶性纳米Fe3O4-阿魏酸抗凝血材料的合成及性能

为提高具抗凝血性能的阿魏酸分子在水中的溶解性进而提高其药效,利用DBI(3,4-二羟基苯甲醛)、PEG(聚乙二醇4000)和纳米Fe₃O₄,采用接枝的方法制备了水溶性纳米Fe₃O₄-DBI-PEG-阿魏酸抗凝血杂化材料,用IR、¹H NMR、TG、SEM、TEM、VSM和粒度测试方法表征了产物。结果表明阿魏酸(FA)接枝在了经过DBI-PEG活化后的纳米Fe₃O₄氧化物表面。杂化材料具有良好的水溶性(溶解度大于10 mg·mL^-1)和顺磁性。抗凝血试验表明相同条件下杂化材料的抗凝血时间和复钙时间比阿魏酸要长,杂化材料的活化部分凝血活酶时间(APTT)和凝血酶原时间(PT)比空白组要长,杂化材料的抗凝血时间随浓度的增大而延长。     

水溶性纳米Fe3O4-阿魏酸抗凝血材料的合成及性能

为提高具抗凝血性能的阿魏酸分子在水中的溶解性进而提高其药效,利用DBI(3,4-二羟基苯甲醛)、PEG(聚乙二醇4000)和纳米Fe₃O₄,采用接枝的方法制备了水溶性纳米Fe₃O₄-DBI-PEG-阿魏酸抗凝血杂化材料,用IR、¹H NMR、TG、SEM、TEM、VSM和粒度测试方法表征了产物。结果表明阿魏酸(FA)接枝在了经过DBI-PEG活化后的纳米Fe₃O₄氧化物表面。杂化材料具有良好的水溶性(溶解度大于10 mg·mL^-1)和顺磁性。抗凝血试验表明相同条件下杂化材料的抗凝血时间和复钙时间比阿魏酸要长,杂化材料的活化部分凝血活酶时间(APTT)和凝血酶原时间(PT)比空白组要长,杂化材料的抗凝血时间随浓度的增大而延长。     

褐藻糖胶及其与胶原复合物的体外抗凝血活性研究

用FTIR、UV对从海带中提取的褐藻糖胶结构进行了分析。采用部分凝血活醇时间、凝血酶原时间和凝血醇时间作为评价标准，对其体外抗凝血活性作了初步的评价，并与肝素的抗凝血活性作比较。结果表明：褐藻糖胶具有类似肝素的多糖结构，具有较好的抗凝血活性，但低于肝素。将褐藻糖胶固定于胶原上，所得的胶原-褐藻糖胶复合物仍具有一定的抗凝血活性。     

阿魏酸过渡金属配合物的合成及抗凝血作用研究

用阿魏酸与Fe、Co、Ni、Cu、Zn的硝酸盐制备了5种过渡金属配合物,通过红外光谱、热重-差热分析、元素分析、荧光和紫外光谱的方法对配合物进行了表征,确定了配合物的组成。并对配体和配合物进行了全血凝血时间、复钙时间、活化部分凝血活酶时间、凝血酶原时间的测定,结果表明5种配合物具有较好的抗凝血性质。通过荧光光谱、紫外光谱、圆二色谱研究了配合物与人血清白蛋白(HSA)的相互作用,HSA的荧光光谱表明配合物对其有荧光猝灭作用并使其发射峰位置红移,紫外光谱表明配合物的加入导致HSA吸收强度增加且吸收峰位置紫移,圆二色谱表明配合物的存在可引起HSA构象的变化。推测配合物抗凝血作用的起效与其和血清白蛋白之间的相互作用有一定的联系。     

Undariase,a Direct-Acting Fibrin(ogen)olytic Enzyme from Undaria pinnatifida,Inhibits Thrombosis In Vivo and Exhibits In Vitro Thrombolytic Properties

A direct-acting fibrinolytic serine protease named undariase possessing anticoagulant and antiplatelet properties was purified from Undaria pinnatifida. Undariase showed a molecular weight of 50 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and mass spectrometry. It displayed a strong fibrin zymogram lysis band corresponding to the same molecular mass. The N-terminal sequence of undariase, LTATTCEELAAAPTD, does not match with any known fibrinolytic enzyme. The enzyme was stable and active at high temperatures (35–70 °C). The fibrinolytic activity of undariase was strongly inhibited by phenylmethylsulfonyl fluoride (PMSF) and 4-(amidinophenyl) methanesulfonyl fluoride (APMSF). The K _m and V _max values for substrate S-2251 were determined as 6.15 mM and 90.91 mM/min/ml, respectively. Undariase resulted in clot lysis by directly cleaving α and β chains of fibrin. Similarly, it preferentially acted on the Aα chain of fibrinogen followed by cleavage of the Bβ chain. It significantly prolonged the PFA-100 closure times of citrated whole human blood. In addition, undariase delayed the coagulation time and increased activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT). Undariase exerted a significant protective effect against collagen plus epinephrine-induced pulmonary thromboembolism in mice. It prevented carrageenan-induced thrombus formation in the tail of mice. It also resulted in prolongation of APTT ex vivo. In conclusion, these results suggested a therapeutic potential of undariase for thrombosis.     

In vitro evaluation of cellulose acetate hemodialyzer immobilized with heparin

In this study, heparin was immobilized onto cellulose acetate hollow fibers to improve the anticoagulation performance during hemodialysis. In vitro evaluation was carried out using mini‐hemodialyzer circulating with fresh porcine whole blood to simulate kidney therapy. The dialysis performance and hemocompatibility were estimated. The results showed that heparinized hemodialyzer could be used through out the whole dialysis time (4 hr) without injecting additional heparin to prevent coagulation in the dialysis system. In addition, the hemocompatibility was evaluated by measuring activated partial thromboplastin time (APTT), prothrombin time (PT), and fibrinogen time (FT). The complete blood count (CBC) including red blood cell (RBC), hemoglobin (Hgb), hematocrit (Hct), white blood cell (WBC), and platelet were determined. The results showed that heparinization could keep the CBC stable during dialysis, whereas unmodified cellulose acetate hemodialyzer would cause a decrease in RBC unless heparin was injected during dialysis. Heparinized hemodialyzer showed longer APTT, PT, and FT than unmodified hemodialyzer. Heparinized hemodialyzer also showed slightly higher clearance than unmodified hemodialyzer. These results indicated that the dialysis performance and hemocompatibility of cellulose acetate hemodialyzer could be improved by the immobilization of heparin. Copyright © 2006 John Wiley & Sons, Ltd.