急性肺栓塞家兔血流动力学参数及组织病理学改变  

The Hemodynamic Parameters and Histopathologic Changes of Acute Pulmonary Embolism in Rabbits

作　　者：金会艳[1] 阮丽波[2] 韩毅[3] 李树清[4] 

机构地区：[1]昆明医科大学基础实验教学中心机能学实验室,昆明650500 [2]云南省第一人民医院内干科,昆明650032 [3]昆明医科大学基础医学院生理系,昆明650500 [4]昆明医科大学基础医学院病理生理学教研室,昆明650500

出　　处：《微循环学杂志》2012年第3期7-10,75,共5页Chinese Journal of Microcirculation

基　　金：国家自然科学基金(30971171);云南省教育厅科学研究基金(2012C008)

摘　　要：目的:观察急性肺栓塞(APE)家兔血流动力学及组织病理学变化。方法:从家兔颈静脉注入自体血栓,观察APE后家兔基本表现和死亡率,以及呼吸频率(RR)、平均呼吸深度(MDR);动态监测右心室压力(RVP)和最大上升(下降)速率±dp/dtmax以及颈动脉血压(AP)等血流动力学指标的改变,并行肺组织病理学检查。结果:APE家兔成活率为86.9%。注栓后RR和MDR持续升高,与栓塞前比较均具有统计学差异(P<0.05或P<0.01)。右心室收缩压(RVSP)栓塞即刻达峰值,6h下降到栓塞前,右心室舒张压(RVDP)与栓塞前比较无统计学差异。+dp/dtmax栓塞即刻达峰值,4h下降到栓塞前,-dp/dtmax栓塞即刻升高后恢复到栓塞前。APE后动脉收缩压(SAP)、舒张压(DAP)均持续下降,观察8h也未出现恢复。HE染色可见肺动脉内有血栓及肺小静脉扩张和大量炎性细胞浸润等病理改变。结论:自体血栓经颈静脉注入造成的APE可致血流动力学和肺组织形态学改变,尤以右心室收缩压和AP变化显著。Objective: To observe the hemodynamic parameters and histopathologic changes of acute pulmonary embolism(APE) in rabbits. Method: The autologous blood clots were injected to right ventricle of rabbits by jugular vein injecting. The basic symptoms, mortality, RR and MDR were observed and the RVP, dp/dtmax and AP were monitored after APE in rabbits. Then the lung tissues specimen was observed by HE stain. Results: The survival rate was 86.9% after APE in rabbits. The RR and MDR continued to rise compared with pre-embolisation. The RVSP immediately reached the peak after APE, then it fell to the level of pre-embolization at embolization 6h. The +dp/dtmax immediately reached the peak after APE, it fell to the level of pre-embolization at embolization 2h.The -dp/dtmax was highest at immediate point. The SAP and DAP were lower to 8h. HE stain showed there were thrombi within the pulmonary arteries, the venues dilated and massive inflammatory cells infiltrated. Conclusion: The autologous blood clots were injected to right ventricle of rabbits by jugular vein injecting in order to induce APE led to the changes of hemodynamic and lung tissues morphology, especially in RVSP and carotid AP.

关 键 词：急性肺栓塞 组织病理学改变 血流动力学参数 病理生理综合征 病理生理学改变 家兔 肺血栓栓塞症 血管内皮功能 

分 类 号：R543.2[医药卫生—心血管疾病]