论文部分内容阅读
目的:建立一种良好的适合进行溶栓治疗实验研究的急性肺血栓栓塞动物模型。方法:24只日本大耳白兔,随机分为尿激酶溶栓组(UK组)、模型组(C组)、假手术组(S组),经右心导管注入条柱状自体血栓,心导管法监测血流动力学,制备急性肺血栓栓塞实验模型。在血流动力学和核素肺灌注扫描的基础上观察溶栓疗效,采用透射电镜法观察肺组织超微结构。结果:(1)肺栓塞后放射性核素肺灌注显像可见两肺野放射性分布不均,有放射性缺损和放射性稀疏现象,溶栓治疗后可见放射性充填。(2)肺动脉栓塞后可见肺动脉平均压(PAMP)与注栓前比较均有明显升高(P<0.01),UK组在溶栓开始1h后,PAMP即明显下降(P<0.01),C组PAMP注栓后随时间无显著性变化。(3)组织病理显示,UK组可见肺出血和肺实变,肺泡Ⅱ型上皮细胞脱落,血管内皮细胞损伤,线粒体肿胀,核固缩。C组血管内皮细胞和肺泡上皮细胞损伤较UK组明显减轻。结论:本模型制备方法简便,符合肺栓塞病理生理变化,为肺栓塞溶栓治疗提供了一种较好的动物实验模型。
Objective: To establish a good animal model of acute pulmonary thromboembolism suitable for thrombolytic therapy. Methods: Twenty-four Japanese white rabbits were randomly divided into urokinase thrombolysis group (UK group), model group (C group) and sham operation group (S group) Method to monitor hemodynamics, the preparation of experimental model of acute pulmonary thromboembolism. Thrombolytic therapy was observed on the basis of hemodynamic and radionuclide perfusion scan. The ultrastructure of lung tissue was observed by transmission electron microscopy. Results: (1) Radionuclide pulmonary perfusion imaging after pulmonary embolism shows uneven distribution of radioactivity in both lung fields, radioactive defects and radioactive sparseness, and radioactive filling after thrombolysis. (2) Pulmonary artery mean pressure (PAMP) after pulmonary embolism was significantly higher than that before pre-embolization (P <0.01), PAMP was significantly decreased 1 hour after thrombolysis in UK group (P <0.01), while in C group There was no significant change with time after PAMP infusion. (3) Histopathology showed that the UK group showed pulmonary hemorrhage and lung consolidation, alveolar type Ⅱ epithelial cells shedding, vascular endothelial cell injury, mitochondria swelling and nuclear pyknosis. The damage of vascular endothelial cells and alveolar epithelial cells in group C was significantly reduced compared with UK group. Conclusion: The preparation method of this model is simple and in line with the pathophysiological changes of pulmonary embolism, and provides a better animal experimental model for thrombolytic therapy of pulmonary embolism.