| Objective:.To investigate the effects of adenosine,lidocaine and magnesium sulfate(ALM)on coagulation function in septic rats.Methods: This study consists of two parts.In the first part,62 male Sprague-Dawley rats were randomly divided into three groups: normal control group(NC group,n=6),cecal ligation puncture model group(CLP group,n=28)and autologous fecal intraperitoneal injection model.Group(FIP group,n=28).The CLP group and the FIP group were divided into 3 subgroups(n=6)at 6h,12 h and 24 h after model establishment.In addition,the remaining 10 rats in the CLP group and the FIP group were observed for 72 hours.Rats in each group were treated with abdominal aortic blood after anesthesia at the end of observation time to detect lactic acid(Lac),prothrombin time(PT)and partial thromboplastin time(APTT);enzyme-linked immunosorbent assay(ELISA)was used for detection.Serum interleukin-6(IL-6)were obtained;the small intestine,lung and heart tissues were collected from CLP group and FIP group at 6h and 24 h,and pathological changes were observed under light microscope.In the second part,48 male Sprague-Dawley rats were randomly divided into sham group,sepsis(CLP)group and ALM treatment group,with 16 rats in each group.In the CLP group and the ALM treatment group,a rat model of sepsis was prepared by cecal ligation puncture(CLP).The sham operation group only opened the laparotomy,cecum,and closed the abdomen without ligation.2 hours after model establishment,ALM treatment group was injected with 0.3 ml of ALM from the tail vein,and then ALM was infused into the tail vein at a rate of 0.5 ml/kg/h.The control group and the sepsis group were infused with the same volume of normal saline at the corresponding time points.Eight rats in each group were given blood samples at 6h and 12 h after operation to detect prothrombin time(PT)and activated partial thrombin activation time(APTT),plasma tissue factor(TF),and intercellular cells.The level of adhesion molecule-1(ICAM-1),endothelin-coated core protein(syndecan-1).Results:Part 1.The 72 h mortality rate in the CLP group and the FIP group was 60% and 100%,respectively.Compared with the normal group,the levels of Lac,APTT,and IL-6 in the blood at 6h in the CLP and FIP model groups after operation were increased significantly,and the levels of PT were increased at 24 h in the CLP and FIP groups.Compared with the normal group,the CLP and FIP groups showed pathological damage in the intestinal,lung,myocardial and liver tissues in different degrees at 6 h after operation.Compared with CLP group,the levels of Lac,APTT and IL-6 were increased significantly in FIP group at 6h and 24 h after operation(Lac 2.34±0.21,3.79±0.14 VS 1.79±0.28,3.46±0.21;APTT 28.30±3.03,67.05±22.63 VS 20.23±1.97,24.20±5.14;IL-6 229.60±18.33,149.60±22.52 VS 54.35±21.36,40.95±17.7,both P<0.01).There was no significant difference in PT between CLP group and FIP group at 6h,12 h and 24 h.Part 2.Compared with the sham operation group,the PT of the CLP sepsis group and the ALM treatment group began to prolong at 12 h(both P<0.01),while the APTT,TF,ICAM-1 and Syndecan-1 levels began to increase at 6 h(P<0.01);compared with CLP group,the level of PT was significantly decreased at 12 h in ALM group;plasma TF,ICAM-1 and Syndecan-1 levels were significantly lower at 6h and 12 h than in the same period of sepsis group(both P < 0.01).Conclusion:ALM resuscitation fluid can improve the coagulation function of rats with sepsis.The mechanism may be related to inhibiting the degradation of endothelial polysaccharide coating,reducing the release of tissue factor and reducing the adhesion of endothelial cells to inflammatory cells. |
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