經減壓兔子的瀰散性血管內凝血試驗參數變化

減壓病(decompression sickness，DCS)的原因是體內有氣泡產生而使得血管內凝血因子異常所造成。Philp等人甚至認為減壓病的病因和瀰散性血管內凝血(disseminated intravascular coagulation，DIC)類似。本研究旨在探討經減壓兔子瀰散性血管內凝血參數，如血液中血小板數目(Platelet count)、凝血酵素原時間(Prothrombin time，PT)、活性部分血栓時間(activated partial thromboplastin time，APTT)、纖維蛋白原濃度(concentrati on of fibrinogen)及第八因子濃度(concentration of factor Ⅷ)等的變化。本研究採用32隻雄性紐西蘭種大白兔，體重約2.5±0.5公斤。將其置於動物高壓艙中，以空氣加壓至六大氣壓，45分鐘後再減壓，加壓及減壓之速率皆為每分鐘一大氣壓。在實驗前後，分別抽取兔子靜脈血3.7毫升，分析血液中血小板數目、凝血酵素原時間、活性部分血栓時間、纖維蛋白原及第八因子之濃度。此外，經減壓後在兔子胸前以都卜勒超音波氣泡探測器(Doppler ultrasonic bubble detector)偵測氣泡有無產生。最後將有減壓病症狀的兔子犧牲之，取其肺臟做組織切片分析。結果發現，經急速減壓後：1.在兔子胸骨前方皆可偵測到氣泡產生；2.在肺臟的組織切片中，可發現有微血管腫漲、靜脈有纖維素塊及血小板凝集現象；3.血液中血小板數目、纖維蛋白原濃度及第八因子濃度減少，但凝血酵素原時間、活性部分血栓時間延長。從本研究的肺臟組織切片分析及瀰散性血管內凝血試驗參數變化所得結果，我們認為減壓後所產生的氣泡可以誘導類似瀰散性血管內凝血的症狀。

關鍵字

減壓病；瀰散性血管內凝血

並列摘要

Decompression sickness (DCS) is caused by bubble formation which induces intravascular coagulation abnormalities. Philp et al. further suggested that DCS was similar to disseminated intravascular coagulation (DIC). This report is to study the changes of parameters of DIC such as platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), concentration of fibrinogen and factor Ⅷ in decompressed rabbits. Thirty-two male New Zealand rabbits, 2.5±0.5 kg in weight, were subjected to a simulated air-dive profile of 6 ATA for 45 min in a hyperbaric animal chamber. All the descent and ascent rates were at 1 ATA/min. Both before and after dive, 3.7 ml of venous blood were taken, measured for platelet count, PT, APTT, fribrinogen and factor Ⅷ. The bubble signals were detected over precordium with a Doppler ultrasonic bubble detector after dive. After observation of clinical symptoms the rabbits were scarified and the lungs were taken for pathology (classified by the Philp's pathology score). All subjects showed positive findings of bubble signal after dive. The pathological findings of lungs demonstrated the evidences of capillary engorgement, venous fibrin clots and platelet aggregates. The changes of parameters in DIC test after dive showed that there were decreases in the concentrations of platelets, fibrinogen, and factor Ⅷ and prolongation of PT and APTT. From our laboratory changes of blood and the pathological findings of lungs, we suggested that the bubble formation from decompression could induce a syndrome similar to that seen in DIC.

並列關鍵字

decompression sickness ； disseminated intravascular coagulation

國際替代計量

經減壓兔子的瀰散性血管內凝血試驗參數變化

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