溶栓治疗对急性肺血栓栓塞症肺组织ET-1和NF-κB表达的影响

目的 :探讨急性肺血栓栓塞症 (APTE)时肺组织内皮素 (ET) 1和核因子 (NF) κB的表达及尿激酶 (UK)对其的影响。方法 :3 6只兔随机分为对照组、APTE模型组和UK治疗组。采用自体血栓回输法建立动物模型。常规光镜下病理学检测和免疫组化法检测肺组织ET 1和NF κBP65的表达。结果 :病理组织学显示 :栓塞后肺动脉内血栓形成 ,肺组织萎缩、出血、炎性反应明显。UK溶栓治疗后血栓栓塞和出血减轻 ,炎性反应仍较明显。免疫组化显示 :栓塞后肺组织ET 1和NF κBP65阳性表达明显增强 ,溶栓后ET 1阳性表达显著下降 ,NF κBP65略有升高。结论 :APTE后溶栓治疗可降低ET 1和活化的NF κB介导的肺动脉高压和急性肺损伤。提示PTE临床溶栓治疗时 ,要重视必要的抗炎治疗和内皮素抑制剂或受体拮抗剂的使用

Studies on Expression of Endothelin-1 and Unclear Factor-κB for the Lung Tissue in Dissolution Thrombus Therapy of Acute Pulmonary Thromboembolism

Objective: To study the expression of endothelin 1(ET 1) and unclear factor κB(NF κB) for lung tissue and effect of urkinase(UK) in acute pulmonary thromboembolism(APTE).Method: Thirty six rabbits were divided at random into control(C) group, acute pulmonary thromboembolism(APTE) model group and UK therapy group. APTE model of rabbits was established by intravenous injection of autologous blood clots. At the end, the rabbits were sacrificed and lung removed. The pathological changes for lung tissues were examined with light microscopy. By using immunohistochemistry, the express of ET 1 and NF κB P65 for lung tissues were examined.Results: Histopathologic analysis: After embolism, thrombus is discovered in pulmonary artery and the lung tissue showed atrophy, hemorrhages and inflammatory reaction evidently. After UK treatment, embolism and hemorrhages is lightened, but inflammatory reaction are in evidence still. Immunohistochemistry showed: After embolism, the express of ET 1 and NF κB P65 for lung tissue are increased markedly. UK group,the expression of ET 1 is decreased and NF κB P65 is increased slightly.Conclusion: After APTE, the dissolution thrombus therapy may decreased pulmonary hypertension and acute lung injury induced by ET 1 and active NF κB. Therefore, not only dissolution thrombus therapy but also ant inflammatory treatment and using ET 1 inhibitor or receptor antagonist are necessary.