实验性肺栓塞血栓演变及其意义

目的:研究实验性肺血栓栓塞症(PTE)后血栓演变过程.材料与方法:利用猪自体血栓制备选择性急性PTE模型,观察PTE后不同时间血栓性状、肺动脉内膜和周围肺组织的病理变化.结果:PTE后2 h血栓已部分溶解,3 d继发混合血栓形成,7d血栓部分机化,14d血栓进一步机化并局部钙化;栓塞后即出现肺出血和肺水肿,以2h最为明显;栓塞后1d开始出现内膜增厚,持续到14d.结论:血栓自溶、机化及肺动脉内血栓形成共同决定栓子的结局,影响PTE的病理和临床转归.

Evolution of Thrombus and Its Significance after Experimental Pulmonary Thromboembolism

Objective: To explore the evolution process of thrombus after acute experimental pulmonary thromboembolism (PTE).Materials and Method: Selective left lower lobe pulmonary artery occlusion was performed in fifteen pigs with transcatheter autologous blood clots injection until PTE was cofirmed with angiography.The process of resolution, extension and organization of thrombus after acute PTE was observed grossly and microscopically,and intima and inflammation were also evaluated.Results:Emboli were partly dissolved at 2 h, thrombosis was observed at 3 d, and appeared to organize at both 7 d and 14 d.Pulmonary hemorrhage and pulmonary edema ccursed instantly after PTE and peaked at 2 h. Inflammation of alveolar wall presented at 2 h, and intimal hyperplasia appeared at 1d,both of which persisted through 14days.Conclusion: The interaction between resolution and organization of emboli,associatting with thrombosis, determines the consequence s of emboli,and influence the pathological characteristics and clinical outcome of PTE.