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目的 探讨人工血浆代用品进行离体不同程度血液稀释对凝血功能的影响。方法采取10名成年男性健康志愿者静脉血在离体状态下按不同液体分组分别用10％羟已基淀粉(HES)、琥珀酰明胶(血定安)及聚明胶肽(海脉素)进行33％、50％、66％稀释,并以未稀释的全血作为基础值。血样本用Sonoclot凝血和血小板功能分析仪(sonoclot分析仪)进行动态的凝血功能检测,包括凝结时间(sonACT)、凝结速率及血小板功能(PF);同时采用常规实验室方法检测血细胞比容(Hct)、血小板计数(Plt)、活化部分凝血活酶时间(APTF)以及纤维蛋白原(Fig)含量。结果 Sonoclot分析仪检测显示33％稀释后sonACT均显著缩短(P<0.05),50％及66％稀释时平衡液、海脉素、血定安三组sonACT仍比基础值显著缩短,而HES组66％稀释时显著延长(P<0.01);33％稀释时HES组凝结速率较基础值显著降低,平衡液、海脉素、血定安三组无明显变化;50％及66％稀释时,各组凝结速率均显著降低,以海脉素组降低幅度最小(P<0.01);33％稀释时血定安组PF显著降低(P<0.01),50％及66％稀释时HES组和血定安组显著降低(P<0.01),而平衡液和海脉素组无明显变化。常规实验室检测显示Hct、Plt、Fig均随稀释程度加重进行性降低,APTT随稀释程度加重进行性延长。结论 血液稀释后凝血功能与血液稀
Objective To investigate the effects of artificial plasma substitutes on blood coagulation in vitro with different degrees of hemodilution. Methods Venous blood of 10 healthy male volunteers were administered with different concentrations of 10% hydroxyhexyl starch (HES), succinyl gelatin (HPA) and polygeline %, 50%, 66% dilution with undiluted whole blood as a baseline value. Blood Samples Dynamic coagulation tests, including sonACT, clotting rate and platelet function (PF), were performed using the Sonoclot Coagulation and Platelet Function Analyzer (sonoclot analyzer); routine laboratory methods were also used to determine hematocrit (Hct ), Platelet count (Plt), activated partial thromboplastin time (APTF) and fibrinogen (Fig). Results Sonoclot analyzer showed that sonACT was significantly reduced after 33% dilution (P <0.05), while sonACT was significantly shorter than baseline in 50% and 66% (P <0.01). The coagulation rate of HES group at 33% dilution was significantly lower than that at baseline, and there was no significant change in balance solution, (P <0.01). The PF of Xuedingan group was significantly lower at 33% dilution (P <0.01), while the HES group and Xuedingan group were significantly lower at 50% and 66% dilution (P <0.01), while there was no significant change in the balance solution and the Kaifeng group. Routine laboratory tests showed that Hct, Plt, and Fig decreased with the degree of dilution, while APTT increased with dilution. Conclusions After hemodilution coagulation and blood thinning