急性肺血栓栓塞溶栓治疗动物实验研究.docVIP

急性肺血栓栓塞溶栓治疗动物实验研究 　　摘要：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(P 　　关键词：溶栓治疗；肺血栓栓塞；动物模型；超微结构 　　中图分类号：R332文献标识码：A文章编号：1673-7717(2012)03-0576-04 　　Experimental Study of Thrombolytic Therapy in Acute Pulmonary Thromboembolism 　　JIANG Qin?hua1, XU Wen1, LI Guo?ping1, CHEN Yan?fan2, WANG Liang?xing2, CHEN Shao?xian2 　　(1.Tongde Hospital of Zhejiang Province,Hangzhou 310012,Zhejiang,China; 　　2.The First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000,Zhejiang,China) 　　Abstract: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 　　1.2肺栓塞动物模型的制备 　　1.2.1麻醉动物3%异戊巴比妥钠30mg/kg兔耳缘静脉麻醉后，仰卧位水平固定兔于动物操作台上。行气管插管，连接DW-2000动物人工呼吸机（上海嘉鹏科技有限公司）辅助通气。吸入空气、呼吸频率30次/min、潮气量15mL/kg。 　　1.2.2置入导管游离左颈动脉和右颈外静脉，经左颈动脉穿刺插入聚乙烯导管留置。经右颈外静脉置入深静脉穿刺管（美国ARROW公司）至肺动脉，导管另一端通过YL-4型压力传感器与SJ-42型四道生理记录仪相连，记录肺动脉压力波。为避免凝血，各管路均间断使用灭菌生理盐水封管。 　　1.2.3自体血栓制备从颈动脉抽血0.5mL，注入含凝血酶10U的聚乙烯管（直径为1mm）中，放置37℃水浴箱水浴20min。将血栓置于消毒平皿上切成长约3~4mm柱行血栓，用灭菌生理盐水反复冲洗后，记数50个备用。 　　1.2.4输入自体血栓经深静脉导管注入柱形自体血栓（直径1mm，长度3~4mm），反复注入使肺动脉收缩压（PASP）维持于40~50mmHg左右，共3