化学性ARDS肺循环血中纤维蛋白原水平及其临床意义研究

目的探讨纤维蛋白原(FBG)在化学性急性呼吸窘迫综合征(ARDS)发病机制中的可能作用。方法经尾静脉注射油酸制备ARDS大鼠模型，采用凝血酶法测定ARDS大鼠肺循环、颈动脉和静脉血浆中FBG含量。结果给大鼠静脉注射油酸后0．5h，肺循环血中FBG水平即呈增加趋势，6h显著高于对照组(2495．0±338．9)mg/Lvs(1572．0±286．8)mg/L，P＜0．01]，12h达峰值(3446．7±317．2)mg/L]，72h仍维持在较高水平；12h、24h大鼠颈动脉、静脉血中FBG亦显著高于对照组。结论ARDS在鼠肺循环血中FBG水平持续升高，且与ARDS病程有密切关系，提示FBG可能在介导肺血管内微血栓的形成、引起肺循环功能障碍以及肺纤维化中具有关键作用；肺循环血中FBG水平的监测对指导ARDS的临床治疗及预后评价也可能有重要参考价值。

Role of fibrinogen in pulmonary artery blood in pathogenesis of acute respiratory distress syndrome

Objective This study was designed to investigate possible role of fibrinogen (FBG) in the development and progresssion of acute respiratory distress syndrome (ARDS) induced by oleic acid (OA). Methods An oleic acid-induced ARDS model in male SD rats was established and concentrations of plasma FBG in pulmonary artery, jugular artery and vein of rats 0.5, 2, 6, 12, 24, 72 h after injection with OA via tail vein were analysed sequentially. Results There was an increased trend for pulmonary artery FBG in rats at 0.5 h post OA injection. The median pulmonary artery FBG level of rats at 6 h post OA injection was significantly higher than that of control (2 495.0±338.9) mg/L versus (1 572.0 + 286.8) mg/L, P＜0.01], reaching a maximal peak about 12 h (3 446.7 + 317.2)mg/L], and then slightly declining. The concentration of FBG in jugular artery of rats at 12 h, 24 h post OA injection also was significantly higher than that of control. Conclusion These results suggested that elevation of FBG in pulmonary artery play an important role in the development and progression of ARDS.