实验性急性肺栓塞后炎性细胞的超微结构改变  

Ultrastructure changes of inflammatory cells in pulmonary artery of experimental acute pulmonary embolism

作　　者：张敬霞[1] 陈永利[2] 王佩显[2] 孙根义[1] 袁志明[3] 白景文[4] 

机构地区：[1]天津市胸科医院,天津300051 [2]天津医科女学总医院,天津300052 [3]天津医科大学总医院,天津300052 [4]天津医科大学,天津300070

出　　处：《中国心血管杂志》2004年第5期326-327,336,共3页Chinese Journal of Cardiovascular Medicine

基　　金：天津市自然科学基金资助项目(项目编号:013609011)

摘　　要：目的探讨急性肺栓塞后在栓塞肺动脉局部炎性细胞的超微改变和临床意义。方法 建立急性肺栓塞动物模型,取材栓塞3h、8h和24h的栓塞部位和正常肺动脉,固定液固定后送检。结果正常肺动脉内皮细胞完整,内皮下无水肿。内弹力层波浪状,未见异常。内皮下无淋巴细胞浸润。肺栓塞后3h可见内皮细胞大片脱落,内弹力层断裂。内皮下水肿,液压增高,且可见淋巴细胞浸润、活化。肥大细胞胞浆颗粒显著,部分颗粒核心溶解,并见肥大细胞毗邻淋巴细胞,个别肥大细胞颗粒排空呈空囊,核固缩凝集。结论急性血栓性肺栓塞后激活了栓塞肺动脉的炎性反应,该反应对局部血栓的溶解起着一定作用。Objective To investigate the changes of ultrastructure of inflammatory cells in pulmonary artery and its clinical significance after acute pulmonary embolism (APE). Methods After establishing the model of acute pulmonary embolism in rabbit, the specimens were obtained in both normal and lesion pulmonary artery after APE 3 hours, 8 hours and 24 hours, and to be examined with scaning electron microscope. Results In un-embolismed pulmonary artery, the endothelium cells are intigrity and there is no edema under the endothelium. Intra-elasitic layer is wave-form, and no abnormality can be found. 3,8, and 24h after embolism, all these changes can be found: some of the endothlium cells of the pulmonary artery denudate, collagen and elastic fiber expose to the surface of the vessel, part of the elasitic fiber collapse. Lymphocyte infiltrate and activate. Mast cells are also activated, particles in cytoplasm are prominent, some mast cell abut on lymphocyte. Conclusion After acute pulmonary embolism , the artery endothelium cells are severely injuried and the structure under the undothelium are altered, which may influence the prognosis of the thrombus.

关 键 词：肺动脉 急性肺栓塞 炎性细胞 内皮 肥大细胞 改变 皮下 固定液 局部 反应 

分 类 号：R563.5[医药卫生—呼吸系统] R543[医药卫生—内科学]