门冬氨酸钾镁对低氧性肺动脉高压大鼠肺组织血栓素A2、前列环素及肺腺泡内动脉结构的影响

慢性低氧性肺动脉高压(HPH)的形成与腺泡内肺小动脉内皮增生、肥厚及无肌型动脉向肌型动脉转化有关[1]。血栓素A2(TXA2)、前列环素(PGI2)之间存在相互调控关系,对HPH起着重要的作用。门冬氨酸钾镁是门冬氨酸钾盐与镁盐的等量混合物,目前临床上广泛应用于治疗心血管疾病。本实验建立慢性HPH大鼠模型,旨在观察门冬氨酸钾镁对低氧性肺血管结构重建(HPVR)及肺组织TXA2、PGI2含量的影响,探讨低氧性肺血管结构重建的机制及防治作用。材料与方法1雄性Wistar大鼠21只,体质量210～310g,随机分对照组,低氧组[大鼠置在常压低氧舱内,氧浓度在…     

肺腺泡内动脉构形重建与肺动脉高压等的关系

以野百合碱一次性皮下注射复制大鼠肺动脉高压和肺心病模型。应用光镜、电镜、免疫组织化学和形态定量等方法，观察了肺腺泡内动脉不同病变在肺动脉高压中的作用。结果表明了肺循环功能与结构之间的关系，反映出肺腺泡内动脉构形重建是肺动脉高压形成的病理学基础。结果提示肺腺泡内动脉壁周细胞的增生和肌样分化，对无肌型肺动脉的肌化意义重大。     

腹部枪伤时颈总动脉内血流动力学变化的模拟实验

为了探讨腹部枪伤时脑损伤的发生机制，本研究设计了模拟实验，在模拟腹部枪伤瞬间用压力传感器测试并计算了模拟总动脉内血流动力学变化。实验结果显示枪击瞬间颈总动脉内压力高，压力上升速度快，血流速度快，压差大，流量大。大量血流从颈总动脉急速涌向脑部必须导致脑部的损伤。     

肺高压相关肺循环血流动力学计算模拟研究进展

肺高压（pulmonary hypertension,PH）是由不同病因引起、以肺血管阻力和压力进行性升高为特点的一种致死性疾病,异常血流动力学在其发生发展中具有重要作用。计算流体动力学（computational fluid dynamics, CFD）作为一种新方法 应用于临床研究中,可无创获取患者个体化病灶部位三维空间任一点的血流动力学指标,并可通过可视化技术将其呈现,逐渐成为一种可深入了解血流相关疾病进展的有力工具。对近年来CFD应用于肺高压相关肺循环血流动力学研究中涉及的数值模拟方法、边界条件、血液特性以及主要的血流动力学参数进行综合阐述。     

大鼠慢性缺氧时血浆心钠素和血管紧张素Ⅱ的变化及其与血流动力学变化的关系

连续减压缺氧15天后,大鼠肺动脉压(PAP)明显增高,(P<0.001),延长缺氧时间达40天时,PAP仍维持在同一高水平,体循环动脉压和左、右心室收缩功能无明最变化。缺氧40天组血浆心钠素显著升高(p<0.001).血管紧张素Ⅱ明显降低(P<0.05)。结果说明:在慢性缺氧情况下.ANP和A Ⅱ对血流动力学起着重要的调节作用,它们能限制肺动脉高压的进一步发展,并使体动脉血压维持在正常水平。     

缺氧影响erbB癌基因在大鼠肺内的表达

所氧性肺动脉高压的确切发病机理目前仍不甚清楚。本文以原位杂交技术观察了癌基因ｅｒｂＢ在缺氧大鼠肺内的表达情况，结果发现缺氧７天后，大鼠肺组织内ｅｒｂＢ ｍＲＮＡ表达明显增加，并一直持续至缺氧２１天后，提示ｅｒｂＢ癌基因可能与缺氧引起的肺血管结构的改建过程有关。     

超氧阴离子对缺氧大鼠肺内动脉乙酰胆碱舒张反应的影响

本文应用微量生物测定法观察超氧阴离子在慢性缺氧影响肺内动脉乙酰胆硷舒张反应中的作用。发现慢性缺氧可明显减弱大鼠肺内动脉的ACh内皮依赖性舒张,超氧化物歧化酶则可使此舒张反应恢复到正常水平。利用黄嘌呤—黄嘌呤氧化酶系统产生氧自由基(主要为O_2~((?))可削弱正常大鼠肺内动脉的ACh舒张反应,同样SOD可保护其免遭外源性氧自由基的损伤。结果表明慢性缺氧使肺血管氧自由基(尤其是O_2~((?))产生增多是大鼠肺内动脉ACh舒张反应受到损伤的原因之一。     

先天性心脏病伴肺动脉高压肺组织中腺泡内动脉转化生长因子-β1 mRNA和内皮素-1 mRNA的表达及意义

目的探讨转化生长因子-β1(TGF-β1)和内皮素-1(ET-1)在先天性心脏病(先心病)伴肺动脉高压(PH)的肺组织腺泡内肺动脉中的表达及意义.方法收集51例肺组织,其中41例为左向右分流型先心病患儿[伴PH 25例(A组),无PH 16例(B组)],对照组10例(C组),应用原位杂交、图像分析检测51例腺泡内肺动脉(IAPA)TGF-β1 mRNA和ET-1 mRNA的表达及平均吸光度值(A值);透射电镜观察肺组织超微结构;弹力纤维(VG)染色显示腺泡内肺动脉并计算其数量的变化.结果 (1)肺腺泡内部分肌型及环肌型动脉的数量,A、B两组分别与C组比较, F值分别为149.96、142.01,P<0.01;(2)电镜观察,有的肺小动脉内皮细胞增生;中膜平滑肌增厚,平滑肌细胞面积增大;外膜胶原纤维密集;毛细血管基膜增厚;(3)原位杂交发现,TGF-β1 mRNA在A、B两组腺泡内肺动脉均有阳性表达,A值分别为(0.1988±0.0498)、(0.1098±0.0428),C组表达微弱(A值=0.0578±0.0096),A、B、C三组间比较差异有统计学意义(P<0.05);ET-1 mRNA 在A、B两组肺腺泡内肺动脉内皮细胞表达明显增强,A值分别为(0.1692±0.0205)、(0.1004±0.0140),C组仅有微弱表达(A值=0.0746±0.0119),A、B、C三组间比较差异有统计学意义(P<0.01).结论左向右分流型先心病患儿肺组织腺泡内部分肌型及肌型动脉数量明显增加,肺血管结构重组,TGF-β1 mRNA、ET-1 mRNA表达增高与先心病伴PH的发生有关系.     

肺血管顺应性的变化和结构重组在肺动脉高压形成中的作用

本实验观察了慢性低压缺氧不同时间对大鼠肺血管顺应性和结构的影响,结果表明缺氧4天肺血管顺应性下降,伴有肺泡区非肌性小血管肌化增加;缺氧15天顺应性继续下降,肌化小血管数进一步增加,同时平滑肌中层增厚;缺氧40天顺应性、肌化小血管数和平滑肌厚度不再继续改变。提示缺氧性肺动脉高压的发展和维持与肺血管顺应性及结构的重组有关。     

Contribution of calcium-activated chloride channel to elevated pulmonary artery pressure in pulmonary arterial hypertension induced by high pulmonary blood flow

The correlation between calcium-activated chloride channel (CaCC) and pulmonary arterial hypertension (PAH) induced by high pulmonary blood flow remains uncertain. In this study, we investigated the possible role and effects of CaCC in this disease. Sixty rats were randomly assigned to normal, sham, and shunt groups. Rats in the shunt group underwent abdominal aorta and inferior vena cava shunt surgery. The pulmonary artery pressure was measured by catheterization. Pathological changes, right ventricle hypertrophy index (RVHI), arterial wall area/vessel area (W/V), and arterial wall thickness/vessel external diameter (T/D) were analyzed by optical microscopy. Electrophysiological characteristics of pulmonary arterial smooth muscle cells (PASMCs) were investigated using patch clamp technology. After 11 weeks of shunting, PAH and pulmonary vascular structural remodeling (PVSR) developed, accompanied by increased pulmonary pressure and pathological interstitial pulmonary changes. Compared with normal and sham groups, pulmonary artery pressure, RVHI, W/V, and T/D of the shunt group rats increased significantly. Electrophysiological results showed primary CaCC characteristics. Compared with normal and sham groups, membrane capacitance and current density of PASMCs in the shunt group increased significantly, which were subsequently attenuated following chloride channel blocker niflumic acid (NFA) treatment. To conclude, CaCC contributed to PAH induced by high pulmonary blood flow and may represent a potential target for treatment of PAH.     

门静脉高压症猪肺血管的结构重建及临床意义

目的:探讨门静脉高压症猪肺血管形态结构重建的特点。方法:采用健康2月龄湖北白猪14头,随机分为正常对照组和实验组,用四氯化碳建立门静脉高压症模型。取肺动脉和肺静脉,横断切片。用Pilloridine和Cy3-IgG分别染胶原纤维和平滑肌,弹性纤维自发荧光。在激光共聚焦显微镜下观察,用计算机图像分析系统测量各结构成分的相对含量。结果:与正常对照组相比,门静脉高压猪肺血管壁中胶原纤维、平滑肌的相对含量及胶原纤维与弹性纤维的比值(C/E)均增大,弹性纤维则减少。结论:门静脉高压时,猪肺血管的形态结构可发生重建,表现为胶原纤维增加,弹性纤维减少,导致C/E值的改变。肝肺联合移植时,移植材料间的结构成分的差异也应引起关注。     

Structural and Conformational Changes in Myocardial and Erythrocyte Actin during Cardiac Ischemia

Structural and conformational changes in myocardial and erythrocyte actin during cardiac ischemia were studied by the method of fluorescence resonance energy transfer with highly selective fluorescent probes. In contrast to 15-min coronary artery occlusion, 120-min ischemia was accompanied by irreversible structural and conformational changes in the small domain of erythrocyte actin. Posttranslational changes during myocardial ischemia concerned the N- and C-terminal regions of actin and went beyond the allowed conformational fluctuations in the actin molecule without breaking the energy barrier. Our results suggest that under conditions of ischemia, actin of the myocardium and erythrocyte cytoskeleton loses its ability to acquire conformation required for force generation by cardiomyocyte myofibrils and maintenance of elasticity and integrity of the erythrocyte membrane. __________ Translated from Byulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 140, No. 11, pp. 504–507, November, 2005     

红细胞增多时大鼠肺动脉压和血液流变学变化及普萘洛尔对其影响

为了研究红细胞增多对血液流变学和肺动脉高压的影响。同时观察普萘洛尔（心得安）对红细胞增多的治疗作用。将实验大鼠分为三组：对照组;氯化钴引起单纯红细胞增多组：红细胞增多加心得安组。结果发现,单纯红细胞增多引起肺动脉压、右室压增高,所有切变率下尤其低切变率下的全血粘度也增高,红细胞膜流动性降低,下肢肌肉血流量和体表温度下降。肺动脉压与红细胞压积和右室压之间有良好的正相关性。心得安对上述指标无改善作用。提示单纯红细胞增多即可形成肺功脉高压。而心得安对红强胞增多引起的血液流变学和肺动脉压的变化无影响。     

A Study of the Relationship between the Electrocardiogram and Hemodynamics in the Fetal Lamb during Asphyxia

Progressive changes in the S-T interval of the fetal ECG were studied in 22 lamb fetuses, acutely exteriorized and submitted to graded hypoxia. The ECG changes were studied in order to correlate them with cardiovascular function, as measured by heart rate, mean arterial pressure, end diastolic pressure and combined cardiac output, estimated by the thermodilution method, as well as with blood gases and acid-base status. Close correlations were obtained between Pao., pH and base deficit and the severity of ECG changes, graded according to a scoring system. Alterations in the ECG pattern consistently preceeded signs of failing cardiovascular function. Our previous findings indicated that the hypoxic ECG changes could be regarded as a sign of myocardial glycolysis. Accordingly, similar progressive ECG changes could be induced by isoprenaline injections. It is concluded that progressive changes of the S-T interval of the fetal ECG contains information about fetal hypoxic stress before signs of failing cardiovascular function are seen.     

Effect of Chronic Stress during Neonatal Ontogeny on Structural Organization of the Adrenal Gland in Hypertensive NISAG Rats

Structural organization of the adrenal gland was studied in 3-week- and 6-month-old hypertensive NISAG rats subjected to daily handling (10-min separation from mothers) on postnatal days 1-21. Neonatal handling reduces the stress-induced blood pressure rise in adult NISAG rats and modulates the structure of the adrenal cortex and medulla.     

高血压病患者不同左室构型与胰岛素抵抗的相关性

目的探讨高血压患者胰岛素抵抗对左室构型的影响。方法对高血压组164例进行常规心脏超声、空腹葡萄糖（FBG）、空腹胰岛素（FIN）、血脂检查。采用胰岛素敏感指数（HOMA-IR）作为评价胰岛素抵抗指标,按Gnanu分类法将高血压组划分为正常构型、向心性重构组、向心性肥厚组和离心性肥厚组。采用组间比较、相关性分析等统计学方法进行评价。结果高血压患者按左室重量指数（LVMI）分组,两组间空腹胰岛素及胰岛素抵抗差异无统计学意义（P〉0.05）;但按相对室壁厚度（RWT）分组,空腹胰岛素及胰岛素抵抗差异具有统计学意义（P〈0.05）。并且向心性重构组和向心性肥厚组明显高于正常构型组（P〈0.05）,而离心性肥厚组与正常构型组比较差异无统计学意义（P〉0.05）。逐步回归分析显示LVMI与体重指数、收缩压和舒张压呈正相关（P〈0.05～P〈0.01）,RWT与HOMA-IR呈负相关（P〈0.05）。结论胰岛素抵抗可能是高血压患者合并左室肥厚的重要影响因素之一,改善胰岛素抵抗有利于高血压患者左室肥厚的防治。     

经皮椎体成形中椎旁血管渗漏与骨水泥性肺栓塞

背景：通过经皮穿刺向椎体内注射骨水泥可增强椎体强度及稳定椎体,达到止痛目的,但骨水泥可能在注入过程中渗漏入椎旁血管,并通过腔静脉系统回流至右心室进而进入肺动脉造成肺栓塞。 目的：探讨经皮椎体成形中骨水泥椎旁血管渗漏与骨水泥性肺栓塞的关系。 方法：回顾性分析骨质疏松性椎体压缩骨折行椎体成形患者134例,其中出现骨水泥椎旁血管渗漏患者共23例设为实验组,取未出现骨水泥椎旁血管渗漏且有完整影像学资料43例患者设为对照组。通过椎体成形前后行脊柱和胸部X射线检查确定两组患者是否存在骨水泥椎旁血管渗漏及骨水泥性肺栓塞。 结果与结论：134例患者中共有23例出现骨水泥椎旁血管渗漏,占17.2%。出现椎旁血管渗漏的23例中有3例出现骨水泥性肺栓塞,占出现椎旁血管渗漏患者的13%,但均无胸部症状。对照组43例患者中未出现椎旁血管渗漏的患者也未出现骨水泥性肺栓塞,两组比较差异有显著性意义(P=0.039)。提示骨质疏松性椎体压缩骨折患者行椎体成形过程中一旦出现骨水泥椎旁血管渗漏,尽管并无胸部症状仍应警惕骨水泥性肺栓塞可能。     

慢性缺氧和二氧化碳潴留对大鼠脑阴离子转运蛋白mRNA表达的作用

本实验通过向密闭舱内灌沧混合气体的方法，分别复制慢性缺氧，慢性缺氧伴二氧化碳潴留及慢性呼吸性酸中毒大鼠模型，以地高辛标记的脑阴离子转运蛋白（ＡＥ３）ｃＤＮＡ探针，应用核酸原位杂交及点杂交技术，对ＡＥ３ｍＲＮＡ的分布及变化进行检测。结果显示：（１）ＡＥ３ｍＲＮＡ广泛分布于脑组织，其中以呼吸调整中中枢所在部位脑桥深部灰质最为富集，（２）慢性缺氧组ＡＥ２ｍＲＮＡ的相对含量显著地于对照组（Ｐ〈０．０５），