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目的:观察桃红四物合剂对兔股动脉吻合术后凝血功能及磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(AKT)/哺乳动物雷帕霉素靶蛋白(mTOR)信号通路的影响。方法:将30只新西兰大白兔按随机数字表法分为空白对照组、模型对照组、盐酸罂粟碱注射液组以及桃红四物合剂低、中、高剂量组,每组5只。模型对照组、盐酸罂粟碱注射液组以及桃红四物合剂低、中、高剂量组实验兔作股动脉单纯间断端端缝合模型。造模成功后,桃红四物合剂低、中、高剂量组予以不同剂量桃红四物合剂灌胃,模型对照组、空白对照组和盐酸罂粟碱注射液组予以等量生理盐水灌胃。于术前30 min及术后1、2、3、7 d分别取6组实验兔耳缘静脉血检测活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)及PI3K/AKT/mTOR浓度,对6组数据进行统计分析。结果:与空白对照组相比,模型对照组血浆APTT于术后1～7 d均明显缩短(P<0.05)、FIB值于术后1～7 d均明显增高(P<0.05);与模型对照组相比,桃红四物合剂低、中、高剂量组血浆APTT于术后1～7 d均明显延长(P<0.05),桃红四物合剂中、高剂量组血浆FIB值于术后1～7 d均明显减小(P<0.05),桃红四物合剂低剂量组血浆FIB值于术后2～7 d均明显减小(P<0.05);与盐酸罂粟碱注射液组相比,桃红四物合剂中剂量组血浆APTT于术后2～7 d均明显延长(P<0.05),桃红四物合剂高剂量组血浆APTT于术后1～7 d均明显延长(P<0.05),桃红四物合剂中、高剂量组血浆FIB于术后1～7 d均明显减小(P<0.05)。与空白对照组相比,模型对照组血清PI3K、AKT、mTOR的表达浓度在术后1～7 d均明显增高(P<0.05);与模型对照组血清PI3K、AKT、mTOR表达浓度相比,桃红四物合剂低剂量组、盐酸罂粟碱注射液组均于术后7d明显增高(P<0.05),桃红四物合剂高剂量组于术后1～7 d均明显增高(P<0.05),桃红四物合剂中剂量组PI3K及AKT表达浓度于术后2～7 d均明显增高(P<0.05)、mTOR表达浓度于术后3～7 d均明显增高(P<0.05);与盐酸罂粟碱注射液组血清PI3K、AKT、mTOR表达浓度相比,桃红四物合剂中剂量组于术后3～7 d均明显增高(P<0.05),桃红四物合剂高剂量组PI3K及mTOR表达浓度于术后1～7 d均明显增高(P<0.05)、AKT表达浓度于术后3～7 d均明显增高(P<0.05)。结论:桃红四物合剂可以改善兔股动脉吻合术后凝血功能,防止血栓形成,还可以激活PI3K/Akt/mTOR信号通路,促进血管生成,改善动脉吻合术后组织缺血。
Abstract：Objective:To observe the effect of Taohong Siwu decoction on the coagulation function and the signaling pathway of PI3 K(phosphatidylinositol 3-kinase)/AKT(protein kinase B)/mammalian target of rapamycin(mTOR)after femoral artery anastomosis in rabbits. Methods:A total of 30 New Zealand white rabbits were divided into the blank control group,the model control group,the papavine hydrochloride injection group and the low,medium and high dose groups of Taohong Siwu decoction by random number table method,with 5 rabbits in each group. The rabbits in the model control group,papavine hydrochloride injection group and low,medium and high dose groups of Taohong Siwu decoction were treated with the femoral artery simple intermittent end-to-end suture model. After the successful modeling,the low,medium and high dose groups of Taohong Siwu decoction were given the Taohong Siwu decoction,while the model control group,the blank control group and papavine hydrochloride injection group were given the same amount of normal saline. Activated partial thromboplastin time(APTT),fibrinogen(FIB)and PI3 K/AKT/mTOR concentrations were measured in aural venous blood samples from six groups of rabbits 30 min before operation and 1,2,3 and 7 d after operation,respectively. Statistical analysis was conducted on the data of the six groups.Results:Compared with the blank control group,APTT of the model control group was significantly shortened 1 d to 7 d after operation(P<0.05),FIB values were significantly increased from 1 d to 7 d after operation(P<0.05);compared with model control group,APTT in Taohong Siwu decoction low-dose,medium-dose and high-dose groups were significantly prolonged 1 d to 7 d after operation(P<0.05),FIB value of Taohong Siwu decoction medium and high dose groups was decreased significantly from 1 d to 7 d after operation(P<0.05),the FIB value of Taohong Siwu decoction low-dose group was significantly decreased from 2 d to 7 d after surgery(P<0.05);compared with the papaverine hydrochloride injection group,APTT in Taohong Siwu decoction medium dose group was significantly prolonged 2 d to 7 d after surgery(P<0.05),APTT of Taohong Siwu decoction high-dose group was significantly prolonged on 1 d to 7 d after operation(P<0.05). FIB values in Taohong Siwu decoction medium and high dose groups were decreased significantly 1 d to 7 d after operation(P<0.05);compared with the blank control group,the expression concentrations of PI3 K,AKT and mTOR in serum of the model control group were significantly increased from 1 d to 7 d after surgery(P<0.05);compared with the model control group,the expression levels of PI3 K,AKT and mTOR in serum were significantly increased in the low dose group of Taohong Siwu decoction and papaverine hydrochloride injection group on postoperative 7 d(P<0.05),Taohong Siwu decoction high-dose group was significantly increased from 1 d to 7 d after surgery(P<0.05),the expression concentrations of PI3 K and AKT in Taohong Siwu decoction medium dose group were significantly increased from 2 d to 7 d after operation(P<0.05),mTOR expression levels were significantly increased from 3 d to7 d after operation(P<0.05);compared with the papaverine hydrochloride injection group,the expression concentrations of PI3 K,AKT and mTOR in serum of Taohong Siwu decoction medium dose group were significantly increased from 3 d to 7 d after operation(P<0.05),the expression concentrations of PI3 K and mTOR in Taohong Siwu decoction high-dose group were significantly increased from 1 d to 7 d after operation(P<0.05),and the expression concentration of AKT was increased significantly from 3 d to 7 d after operation(P<0.05). Conclusion:Taohong Siwu decoction can improve the coagulation function of rabbit femoral artery anastomosis,prevent thrombosis,activate PI3 K/AKT/mTOR signaling pathway,promote angiogenesis,and improve tissue ischemia after artery anastomosis.
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基本信息:
DOI：10.13210/j.cnki.jhmu.20210526.001
中图分类号:R285.5
引用信息:
[1]谢心军,谢先敏,邝高艳,等.桃红四物合剂对兔股动脉吻合术后凝血功能及PI3K/AKT/mTOR通路的影响[J].海南医学院学报,2021,27(19):1458-1465.DOI:10.13210/j.cnki.jhmu.20210526.001.
基金信息:
校级科研基金（ZYYDX201751）; 研究生科研创新课题（2019CX60）~~
2021-05-26
2021-05-26
2021-05-26