A new model to assess the haemorrhagic potential of various heparin preparations.

A Berstad, C J Bang, I Talstad
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Abstract

In the gastric mucosa, haemostasis is hampered by the acidity and peptic activity of the gastric juice and by the fibrinolytic activity of plasmin. The hostile intragastric environment may be responsible for the unsecure haemostasis, with episodes of rebleeds often seen in gastroduodenal haemorrhage. Secondly, the haemostatic mechanisms of the gastric mucosa are largely independent of platelet aggregation and thus rely mainly on the coagulation system, making the gastric mucosa a unique model to test haemorrhagic effects of anticoagulants. Using a rat gastric chamber technique, we studied bleeding times from induced gastric mucosal lesions after intravenous administration of unfractionated and low molecular weight heparins. The bleeding times were dose-dependently prolonged by all heparins. With unfractionated heparin, significant prolongation of the bleeding times was seen already at a dose of 75 anti-Factor Xa U/kg, proving that the present model is more sensitive than previous models. The bleeding time per unit dose of both Kabi 2165 (p less than 0.05) and enoxaparin (p less than 0.001) was significantly less than that of unfractionated heparin.

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一种评估各种肝素制剂出血潜能的新模型。
在胃粘膜中,胃液的酸性和消化性以及纤溶酶的纤溶活性阻碍了止血。不良的胃内环境可能是不安全止血的原因,胃十二指肠出血常出现再出血。其次,胃黏膜的止血机制在很大程度上独立于血小板聚集,主要依赖于凝血系统,这使得胃黏膜成为检测抗凝剂出血作用的独特模型。利用大鼠胃腔技术,我们研究了静脉给药未分离肝素和低分子量肝素后诱导胃粘膜病变出血的时间。所有肝素均使出血时间呈剂量依赖性延长。对于未分离肝素,在75抗Xa因子U/kg的剂量下,出血时间明显延长,证明本模型比以前的模型更敏感。Kabi 2165组单位剂量出血时间(p < 0.05)和依诺肝素组单位剂量出血时间(p < 0.001)均显著小于未分离肝素组。
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