急性肺栓塞的动物实验研究

目的 用自体血体模拟自然发生的静脉血栓流入肺动脉,制备不同类型的急性肺栓塞动物模型。方法 采用导管方法将家兔自体血栓注入右心房导致急性肺栓塞的发生。通过控制注入血栓的数量,性状和速度,分别模拟出血临床猝死型,急性肺心病型和肺梗塞全塞,同时观察血浆内皮素（ET）,一氧化氮（NO）的消长变化。结果 23只家兔中呈现性临床表现19只,其中急性肺病型11只,肺梗塞型3只,猝死3只,其他原因死亡2只,非显性临床表现4只,急性肺栓塞后ET,NO浓度均有明显升高。结论 注入血栓的数量,形状和速度决定了急性肺栓塞的临床类型,血栓的性状与能否发生肺栓塞有关,血浆ET,NO参与肺栓塞的病理生理过程。

The animal models on different clinical types of acute pulmonary embolism

Objective Thrombus was injected into pulmonary artery with simulated natural vein thrombus to prepare the animal models of acute pulmonary embolism. Methods Thrombus of oneself body was injected to right atrium of rabbit by interventional method in order to cause acute pulmonary embolism (PE). By controlling speed, properties and quantity of thrombus, the different clinical types were imitated, including massive pulmonary embolism (sudden death), acute pulmonary heart diease and pulmonary infarction. At the same time, it was found that the clinical features did not present in all the animals even if thrombus flowed into pulmonary arteries because the properties of thrombus were different. The transformation of endothelins (ET), and nitric oxide (NO), in plasma was also observed. Results Among 23 rabbits the obvious clinical features appeared in 19 rabbits, in which 11 were with acute pulmonary heart disease, 3 with pulmonary infarctions, 3 with sudden death and 2 with death of other reasons; the nondominant clinical features were in 4 rabbits. There was a significant increase in the levels of ET and NO after acute PE in all the models. Conclusion The clinical types of acute PE depended on the quantity, shape and speed of thrombus. The appearance of PE depended on the properties of thrombus which got into pulmonary arteries. The changes of ET and NO in plasma may be involved in the pathophysiological course of PE.