| Summary: | 碩士 === 慈濟大學 === 藥理暨毒理學碩士班/博士班 === 103 === Hydroxyethyl starch (HES) solution is one of the most commonly used plasma volume expanders in clinical practice. However, HES has been recognized to mediate detrimental effects on hemostasis and coagulation profile. The exact mechanisms underlying HES-induced coagulopathy are still undetermined. In this study, the effects of Voluven® (6% HES 130/0.4) on platelet aggregation, fibrin clot formation, clot retraction and fibrinolysis were investigated in the ex vivo experiments, aiming to gain mechanistic insights into HES-mediated coagulopathy. Our results demonstrated that high dose HES treatment induced marginal lengthening of time to achieve maximal platelet aggregation, but did not significantly affect the ADP-induced platelet aggregation. Prothrombin time (PT), but not activated partial thromboplastin time (aPTT) or recalcification time, was significantly shortened by HES. The shortening of prothrombin time was associated with an increase of turbidity of fibrin clot, suggesting that fibrin polymerization was altered in the presence of HES. HES also accelerated clot retraction of platelet-rich plasma in the interaction with thrombin. The formation of fibrin clot in the presence of HES was more subjected to fibrinolysis. Collectively, we conclude that HES has negligible effect on platelet aggregation, but it accelerates the formation of fibrin clot with enhanced fibrinolysis combined.
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