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目的:用不同成分的羊水注入孕兔体内模拟羊水栓塞发生,探讨内皮素-1(ET-1)、血栓烷B2(TXB2)对肺动脉压的影响。方法:将孕兔29只随机分成4组:孕兔原羊水(AF)组、胎粪液(MAF)组、胎盘组织提取液组(PAF)和生理盐水对照(NS)组。在造模前后不同时间点分别抽取血样,检测血浆中ET-1、TXB2的浓度变化,同时连续监测肺动脉压并存储数据。结果:1原羊水组血ET-1、TXB2的水平与对照组相比未见明显差异(P>0.05);胎盘组和胎粪液组ET-1分别于10、15、30 min明显升高与对照组差异有统计学意义(P<0.05);TXB2分别于10、20、40 min明显升高,且胎粪组更为显著(P<0.05)。2肺动脉压变化:与对照组相比,原羊水组升高不明显(P>0.05);胎盘组10 min左右升高,15 min达到高值(P<0.05),40 min后恢复正常;胎粪组30min达到高值(P<0.05),40 min亦未降至正常,且肺动脉压升高更为明显。3原羊水中ET-1含量增高与肺动脉压升高没有明显线性关系(P>0.05);胎盘组和胎粪组中ET-1含量增高与肺动脉压升高均呈显著的正相关(P<0.05)。结论:羊水中不同物质进入血液循环刺激机体ET-1、TXB2的含量升高,ET-1、TXB2与羊水栓塞关系密切;ET-1、TXB2含量增高可导致孕兔肺动脉压升高,且ET-1的含量增高与肺动脉压升高呈显著的正相关(P<0.05)。
OBJECTIVE: To investigate the effects of endothelin-1 (ET-1) and TXB2 on pulmonary arterial pressure (MAP) in pregnant rabbits with amniotic fluid of different composition. Methods: Twenty - nine pregnant rabbits were randomly divided into 4 groups: AF group, MAF group, PAF group and NS group. Blood samples were taken at different time points before and after modeling to detect plasma concentrations of ET-1 and TXB2. Pulmonary arterial pressure was continuously monitored and stored. Results: 1 ET-1 and TXB2 levels in primary amniotic fluid group were not significantly different from those in control group (P> 0.05). ET-1 in placental group and meconium group were significantly increased at 10, 15 and 30 min (P <0.05). TXB2 increased significantly at 10, 20 and 40 min, and the meconium group was more significant (P <0.05). Compared with the control group, the increase of pulmonary arterial pressure was not significant (P> 0.05). The placental group increased at about 10 min, reached a high value at 15 min (P <0.05), and returned to normal after 40 min. Fecal group reached a high value 30min (P <0.05), 40min also did not fall to normal, and pulmonary hypertension was more obvious. There was no significant linear relationship between ET-1 concentration and pulmonary arterial pressure (P> 0.05) in placenta group and meconium group. The ET-1 level in placenta group and meconium group had a significant positive correlation with pulmonary hypertension (P < 0.05). Conclusion: The contents of ET-1 and TXB2 in the amniotic fluid stimulated by blood circulation increased, and ET-1 and TXB2 were closely related to amniotic fluid embolism. The increase of ET-1 and TXB2 could lead to the increase of pulmonary arterial pressure -1 was positively correlated with pulmonary hypertension (P <0.05).