响尾蛇的外事局抗蛇毒素逆转血小板功能障碍引起Crotalus scutulatus毒液:体外研究。
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Carstairs SD, Kreshak AA, Tanen哒
响尾蛇的外事局抗蛇毒素逆转血小板功能障碍引起Crotalus scutulatus毒液:体外研究。
阿德莱德大学地中海紧急情况。2013年5月,20 (5):522 - 5。doi: 10.1111 / acem.12135。
- PubMed ID
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23672368 (在PubMed]
- 文摘
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背景:患者维持响尾蛇表面变质经常出现血小板减少,它的病因还不清楚。实验室研究已经证明,毒液从几个物种,包括莫哈韦沙漠响尾蛇(Crotalus scutulatus scutulatus),可以抑制血小板聚集。在人类中,响尾蛇的工厂管理抗蛇毒素已被证明导致瞬态改善血小板水平;然而,目前尚不清楚血小板聚集也提高了抗蛇毒素后管理。目标:目标是要确定c . scutulatus毒液的作用在体外血小板聚集的存在和没有响尾蛇的外事局抗蛇毒素。方法:血液从四个健康男性成年志愿者不是目前使用阿司匹林,非甾体类抗炎药物,或其他platelet-inhibiting代理。c . scutulatus毒液从一个蛇与已知的B型(出血性)活动是获得国家自然毒素研究中心。测定血小板聚集的凝集计进行了使用五个标准浓度的肾上腺素(一种已知的血小板聚合器)富含血小板血浆随着时间的推移,和平均曲线下的面积(AUC)计算。五个不同的样本组测量:1)血液,2)血液+ c scutulatus毒液(0.3毫克/毫升),3)血液+响尾蛇的外事局抗蛇毒素(100毫克/毫升),4)血液+毒液+抗蛇毒素(100毫克/毫升),和5)血液+毒液+抗蛇毒素(4毫克/毫升)。平均数标准误差(SEM)计算每组,和配对t是用来测量组之间的差别。 RESULTS: Antivenom administration by itself (group 2) did not significantly affect platelet aggregation compared to baseline (103.8%, SEM +/- 3.4%, p = 0.47). Administration of venom (group 3) decreased platelet aggregation (72.0%, SEM +/- 8.5%, p < 0.05). Concentrated antivenom administration in the presence of venom (group 4) normalized platelet aggregation (101.4%, SEM +/- 6.8%) and in the presence of diluted antivenom (group 5) significantly increased aggregation (133.9%, SEM +/- 9.0%; p < 0.05 for both groups when compared to the venom-only group). To further assess the effects of the venom and antivenom, each was run independently in platelet-rich plasma without epinephrine; neither was found to significantly alter platelet aggregation in the absence of epinephrine. CONCLUSIONS: Crotaline Fab antivenom improved platelet aggregation in an in vitro model of platelet dysfunction induced by venom from C. scutulatus. It is unclear at this time whether this improvement in platelet dysfunction translates into improved clinical outcomes in envenomated patients.
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