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目的 探讨急性肺栓塞(APE)对肺血管内皮细胞(PVECs)的结构及血清一氧化氮(NO)含量的影响.方法 19只日本大耳兔,随机分成假手术组、栓塞2h、4h组(n=3)和8h组(n=10).通过输入自体血栓建立家兔急性肺栓塞模型后,采用HE染色光学显微镜下观察肺的病理组织学变化;透射电子显微镜下观察PVECs在肺栓塞2h、4h及8h的超微结构变化;硝酸还原酶法测定相应时间点血清NO含量.结果 HE染色显示栓塞组肺动脉内有血栓,肺间质炎性病变,肺淤血;透射电子显微镜显示,栓塞组PVECs水肿、破裂,线粒体肿胀,内质网空泡化,并随栓塞时间延长PVECs出现坏死脱落,细胞器溶解.肺栓塞2h、4h和8h血清NO含量均低于栓塞前,与栓塞前比较差异有显著性意义(P＜0.05).结论 家兔APE可致PVECs超微结构改变和血清NO含量下降,且两者间关系密切.“,”Objective To study the ultrastructures of pulmonary vascular endothelial cells (PVECs) and the content of nitric oxide (NO) in serum after acute pulmonary embolism (APE) in rabbits.Methods A total of 19 rabbits were randomly divided into four groups:sham (n =3),2 hours after APE (n =3),4 hours after APE (n =3) and 8 hours of APE (n =10).The rabbit model of APE was established by injecting autologous blood clots.Pathological histology changes of the lung were observed under an optical microscope and the ultrastructural changes of PVECs were examined by transmission electron microscopy at the 2ed hour,the 4th hour and the 8th hour after APE.In addition,the content of NO in serum at pre-embolism,2 hours,4 hours and 8 hours after APE was determined by nitrate reductasemethod.Results In the embolism group,the HE staining showed that there were thrombi within the pulmonary arteries.The pulmonary congestion was found in pulmonary arteries and massive inflammatory cells were infiltrated into the arteries.The transmission electron microscope showed PVECs edema,rupture and mitochondrion swell and endoplasmic reticulum emptying.With the longer duration of embolism,PVECs necrosis and exfoliation were observed.The organelles were dissolved.Compared with the pre-embolization,the content of NO significantly decreased at 2 hours,4 hours and 8 hours after APE (P ＜ 0.05).Conclusion APE leads to the ultrastructural changes of PVECs and the content of NO in serum decrease in rabbits.The content of NO in serum is in relation to the ultrastructural changes of PVEC.