溶栓抗凝疗法对血管内皮及血栓与血管黏附特性影响的实验研究.docVIP

溶栓抗凝疗法对血管内皮及血栓与血管黏附特性影响的实验研究 杨 冰1，赵庆华1，赵 渝2（1重庆医科大学附属第一医院护理部，重庆400016；2重庆医科大学附属第一医院血管外科，重庆400016） 提要 目的 研究肝素、尿激酶及其联合治疗急性大鼠下腔静脉血栓（Deep venous thrombosis，DVT）形成后不同时相静脉血栓与血管粘附特性的变化。方法 SD大鼠135只，105只建立大鼠急性下腔静脉血栓模型后随机分为肝素治疗A组、尿激酶治疗B组、联合治疗C组各35只；另30只为假手术组（sham，SH）。各组给药后分别于血栓形成后第1、4、7、14、28d获取目标血管，光镜观察血栓的结构演变与机化程度，内皮层扫描电镜评估内皮细胞形态学变化以及力学测量管壁血栓附着力。结果 7d时B、C组内皮损伤较A组轻（P 0.05）。28d时C组内皮损伤较A、B组轻（P 0.05）。栓后1、4d，B、C组血栓附着力分别较A组低（P 0.01）。结论 肝素加尿激酶治疗大鼠急性下腔静脉血栓形成能有效地保护内皮层完整，减轻血管壁肌纤维增生，但在急性血栓形成早期，残余附壁血栓粘附力相对较低。 关键词 静脉血栓形成； 抗凝溶栓； 血管内皮；粘附 中图法分类号： R654.4； 文献标识码：A Effect of anticoagulation, thrombolysis on adhersion property of phlebothrombosis and vascular endothelial after acute thrombosis in rats YANG Bing,ZHAO Qing-hua,ZHAO Yu（1.Department of Nursing, 2.Department of Vascular Surgery, the First Afflliated Hospital, Chongqing Medical University, Chongqing,400016） Abstract: Objective To study adhersion property of thrombosis and inferior caval vein wall after acute thrombosis in rats. Methods The inferior caval venous thrombosis model were treated with heparin（n = 35），urokinase（n =35），and combination of heparin and urokinase（n =35），respectively. sham group（n =30）. The thrombosed caval veins were taken 1,4,7,14,and 28 days after thrombosis. Construction succession and intimal hyperplsia were observed by light microscope. Scanning electron microscopy was used to observe the damage of endothelial cells on inferior caval vein wall. The power of adhersion of thrombosis was measured on different phases. Results The endothelium damage in A group is serious than group Band C up on day 7（P 0.05）,and the endothelium damage in group C being less than which in on day 28（P 0.05）. Adhersion to caval vein wall in group Band C is lower than A group since day 4 after thrombosis（all P 0.01）. Conclusion Combination of heparin and urokinase for the treatment of acute inferior caval venous thrombosis effectively maintains the integrety of endotheliunm of vein wall and decreases the fibro