多器官衰竭早期血小板粘附与血管内皮细胞的改变

用失血再灌流加内毒素造成多器官衰竭（ＭＯＦ）的方法，在３００～１５００倍显微镜下观察血小板粘附和内皮损伤的改变，探讨血小板粘附和血管内皮损伤对微循环的影响。结果表明ＭＯＦ早期细静脉内皮上除有较多血小板贴壁或粘附在变形性差的白细胞上，细动脉内皮增厚，内皮表面出现较多血小板粘附，管腔内壁粗糙，可见到血流中的血小板迅速地粘附在损伤的内皮上，堆积、溶合形成壁栓。管腔内还有纤维蛋白形成丝网状粘附在血管腔的中间。血小板和纤维蛋白缠络在一起，形成棉絮状的团块在血管内流动。ＭＯＦ的早期细静脉内皮水肿、管壁增厚并有空泡形成，大的空泡占满整个管腔，造成血流受阻。这些改变都是造成ＭＯＦ发生的重要原因。

Changes of Platelets Adhesion and Endothelium at Initial Stage of Multiple Organ Failure in Rat

ffect of platelets adhesion and changes of endothelium at initial stage of multiple organ failure is studied. The experimental model was maked by ischemia/reperfusion plus injection of 1mg endothelium was observed under high magnifying power microscope in vivo. The results showed that the platelets adhesion increased in venule, 1￣3h after reperfusion platelets adhension occurred both in arterioles and venules at initial stage of multiple organ failure. Some platelets adhered on the surface of leukocytes and rolling together with leukocytes in venule. Some platelets aggregated and formed network and filamentous form, adhered on surface of endothelium, to obstruct leukocytes and erythrocytes flowing in venules and arterioles. A thick layer microthrombus that consists of platelets, leukocytes and fibrin adhering to the wall of vessels. All these adhesion, aggregation and microthrombosis in vessels would impede blood flowing and affect blood supply to tissue.