Pang Bao-Sen, Wang Chen, Luo Qin, Zhang Li-Ming, Zhu Min, Mao Yan-Ling, Huang Xiu-Xia, Guo Wen-Jing
Beijing Chaoyang Hospital-Beijing Institute of Respiratory Medicine, Capital University of Medical Science, Beijing 100020, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2004 Jun;27(6):381-4.
To study the functional changes and the significance of coagulation, fibrinolysis and pulmonary vascular endothelium before and after experimental pulmonary thromboembolism in rabbits.
Rabbit pulmonary thromboembolism models by injection of auto-blood clots into femoral vein were used to observe the dynamical changes of activity of coagulation and fibrinolysis and endothelin-1 (ET-1), nitrogen monoxide (NO), von Willebrand factor (vWF) in blood.
Petechial and patchy hemorrhages were observed on the surfaces of embolic lungs. The injected blood clots and secondary thrombosis in the pulmonary arteries, inflammatory cell infiltration around alveoli, local hemorrhages in the alveoli and interstitial tissue could be found by microscopy. The concentration of D-dimer, ET-1 and vWF in blood were significantly elevated, and the tissue-type plasminogen activator (t-PA), NO and antithrombin III (AT-III) decreased significantly after embolism (P < 0.05). After administration of urokinase, the pathological injuries relieved, and the concentration of D-dimer was higher at 1 h and 2 h after embolization than that before embolization (P < 0.05), and reduced to the level of pre- embolization at 4 h after embolization. The levels of t-PA, NO and AT-III after embolization were lower than those before embolization (P < 0.05). The level of ET-1 was higher at 2 h after embolization (P < 0.05) and reduced to the level of pre-embolization at 4 h.
PTE has important impacts on coagulation, fibrinolysis and pulmonary vascular endothelial function. Thrombolysis with urokinase could keep the balance between coagulation and fibrinolysis and protect pulmonary vascular endothelial function.
研究兔实验性肺血栓栓塞前后凝血、纤溶及肺血管内皮的功能变化及其意义。
采用经股静脉注入自身血凝块的方法制备兔肺血栓栓塞模型,观察血液中凝血与纤溶活性及内皮素-1(ET-1)、一氧化氮(NO)、血管性血友病因子(vWF)的动态变化。
栓塞肺表面可见瘀点和片状出血。显微镜下可见肺动脉内注入的血凝块及继发性血栓形成,肺泡周围有炎性细胞浸润,肺泡及间质组织有局部出血。栓塞后血液中D-二聚体、ET-1及vWF浓度显著升高,组织型纤溶酶原激活物(t-PA)、NO及抗凝血酶Ⅲ(AT-Ⅲ)显著降低(P<0.05)。给予尿激酶后,病理损伤减轻,栓塞后1 h和2 h时D-二聚体浓度高于栓塞前(P<0.05),栓塞后4 h降至栓塞前水平。栓塞后t-PA、NO及AT-Ⅲ水平低于栓塞前(P<0.05)。栓塞后2 h时ET-1水平升高(P<0.05),4 h时降至栓塞前水平。
肺血栓栓塞对凝血、纤溶及肺血管内皮功能有重要影响。尿激酶溶栓可维持凝血与纤溶平衡,保护肺血管内皮功能。