急性肺血栓栓塞溶栓治疗的动物实验研究

目的:建立一种良好的适合进行溶栓治疗实验研究的急性肺血栓栓塞动物模型。方法:24只日本大耳白兔,随机分为尿激酶溶栓组(UK组)、模型组(C组)、假手术组(S组),经右心导管注入条柱状自体血栓,心导管法监测血流动力学,制备急性肺血栓栓塞实验模型。在血流动力学和核素肺灌注扫描的基础上观察溶栓疗效,采用透射电镜法观察肺组织超微结构。结果:(1)肺栓塞后放射性核素肺灌注显像可见两肺野放射性分布不均,有放射性缺损和放射性稀疏现象,溶栓治疗后可见放射性充填。(2)肺动脉栓塞后可见肺动脉平均压(PAMP)与注栓前比较均有明显升高(P0.01),UK组在溶栓开始1h后,PAMP即明显下降(P0.01),C组PAMP注栓后随时间无显著性变化。(3)组织病理显示,UK组可见肺出血和肺实变,肺泡Ⅱ型上皮细胞脱落,血管内皮细胞损伤,线粒体肿胀,核固缩。C组血管内皮细胞和肺泡上皮细胞损伤较UK组明显减轻。结论:本模型制备方法简便,符合肺栓塞病理生理变化,为肺栓塞溶栓治疗提供了一种较好的动物实验模型。

Experimental Study of Thrombolytic Therapy in Acute Pulmonary Thromboembolism

Objective:To establish an animal model of acute pulmonary thromboembolism that may be used for thrombolyitc therapy study.Methods:Twenty-four Japanese rabbits were randomly divided into Urokinase group(group UK),control group(group C) and sham operation group(group S).Acute pulmonary embolism models of rabbits were established with injection of autologous blood clots through the right heart catheters.Haemodynamic monitoring were performed by introducing heart catheter through right jugular vein.The ultrastructures of lung tissue were observed by electronic microscope.Results:(1)Radionuclide lung perfusion scan showed radio activity defect or attenuation after embolization and radioactivity filling after thromblysis.(2)PAMP was increased after embolization in both group UK and group C(P<0.01) and decreased immediately at 1 hour after UK administration in group UK(P<0.01),there were no significant changes in PAMP of group C after embolization with time.(3)Histopathologic analysis showed pulmonary hemorrhage and consolidation in group UK,the swelling and karyopyknosis of capillary endothelium were observed in group UK.The injuries of endotheliums and type Ⅱ alveolar cells in group UK were more severe than those in group C.Conclusion:The way of establishment of model is simple.The physiological changes of experimental model accord with the acute pulmonary thromboembolism’s.It provides a good experiment model for thrombolyitc therapy in pulmonary thromboembolism.