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Study of the function of coagulation,fibrinolysis and pulmonary vascular endothelium before and after experimental pulmonary thromboembolism in rabbits
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF TUBERCULOSIS AND RESPIRATORY DISEASES
- Issue:
- 6
- DOI:
- 10.3760/j:issn:1001-0939.2004.06.009
- Key Word:
- 肺栓塞;内皮;抗凝血酶Ⅲ;组织型纤溶酶原激活物;尿激酶
Abstract： 目的探讨实验性兔肺血栓栓塞症(PTE)后凝血纤溶系统、肺血管内皮功能的变化及其临床意义,了解尿激酶对凝血纤溶系统及肺血管内皮功能的影响.方法 24只雄性新西兰大耳白兔随机分为正常对照组、单纯栓塞组及尿激酶组,每组8只.单纯栓塞组及尿激酶组经兔股静脉注入自体血凝块制备兔PTE模型.尿激酶组用尿激酶治疗动态观察尿激酶治疗前后兔凝血纤溶系统活性和血浆中内皮素1(ET-1)、一氧化氮(NO)、血管性血友病因子(vWF)的变化.结果解剖肺脏栓塞部位肉眼观,见肺表面点片状出血灶;镜下肺动脉血管内可见注入的血凝块与继发的血栓形成,肺泡周围有大量炎性细胞浸润,肺泡和间质内有局灶出血.肺栓塞后血D-二聚体(D-dimer)、 ET-1、 vWF水平明显增高,而组织型纤溶酶原激活剂(t-PA)、 NO、抗凝血酶Ⅲ(AT-Ⅲ)水平明显下降(P<0.05).PTE兔经尿激酶治疗后肺脏病理改变减轻, D-dimer水平在栓塞后1及2 h高于栓塞前(P<0.05),4 h后降至栓塞前水平;t-PA、NO及AT-Ⅲ在肺栓塞后低于栓塞前(P<0.05);ET-1在栓塞后2 h高于栓塞前(P<0.05),4 h降至栓塞前水平.结论 PTE对体内凝血纤溶系统及肺血管内皮功能均有重要影响.PTE兔经尿激酶溶栓治疗可维持机体凝血纤溶系统的平衡及保护肺血管内皮功能.
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