CAJ | 학술논문

目的探讨急性肺栓塞肺动脉组织因子(TF)表达水平的改变及临床意义.方法由中国医学科学院血液学研究所提供实验设备和条件.选用日本大耳白纯种家兔34只(实验动物二级,天津医科大学提供),随机(随机数字法)分为肺栓塞3h组(A组)8只,肺栓塞8h组(B组)8只,肺栓塞24h组(C组)8只,实验对照组(D组)10只.沿兔耳缘静脉取血2 mL制成血栓,沿颈静脉插入5F导管并注入血栓,建立急性肺栓塞动物模型.经数字减影检查证实肺栓塞成功.对照组不注入血栓,其余步骤与栓塞组相同.取材栓塞3、8和24 h后的栓塞部位、栓塞远端和对照组正常肺动脉组织,应用RT-PCR方法检测组织内TF mRNA的表达水平.多组均数比较用方差分析,有统计学意义后用两两比较的q检验.结果肺栓塞3、8和24 h组,三组间栓塞部位肺动脉TF表达差异无统计学意义.栓塞3h,8h组,栓塞远端肺动脉TF表达为(0.40±0.29),(0.15 ±0.05)显著低于栓塞部位肺动脉(1.10±0.21),(0.84 ±0.22)和正常肺动脉(0.86 ±0.34)(F值为10.72,20.04,P＜0.01).栓塞24 h组,栓塞、未栓塞和正常肺动脉之间比较差异无统计学意义.结论肺栓塞3h后栓塞远端肺动脉TF表达下降,然栓塞部位TF表达并无下降,这种局部高凝活性不利于血栓的溶解.因此针对栓塞局部的溶栓和抗凝治疗是一种有效的治疗方法.
목적 탐토급성폐전새폐동맥조직인자(TF)표체수평적개변급림상의의.방법 유중국의학과학원혈액학연구소제공실험설비화조건.선용일본대이백순충가토34지(실험동물이급,천진의과대학제공),수궤(수궤수자법)분위폐전새3h조(A조)8지,폐전새8h조(B조)8지,폐전새24h조(C조)8지,실험대조조(D조)10지.연토이연정맥취혈2 mL제성혈전,연경정맥삽입5F도관병주입혈전,건립급성폐전새동물모형.경수자감영검사증실폐전새성공.대조조불주입혈전,기여보취여전새조상동.취재전새3、8화24 h후적전새부위、전새원단화대조조정상폐동맥조직,응용RT-PCR방법검측조직내TF mRNA적표체수평.다조균수비교용방차분석,유통계학의의후용량량비교적q검험.결과 폐전새3、8화24 h조,삼조간전새부위폐동맥TF표체차이무통계학의의.전새3h,8h조,전새원단폐동맥TF표체위(0.40±0.29),(0.15 ±0.05)현저저우전새부위폐동맥(1.10±0.21),(0.84 ±0.22)화정상폐동맥(0.86 ±0.34)(F치위10.72,20.04,P＜0.01).전새24 h조,전새、미전새화정상폐동맥지간비교차이무통계학의의.결론 폐전새3h후전새원단폐동맥TF표체하강,연전새부위TF표체병무하강,저충국부고응활성불리우혈전적용해.인차침대전새국부적용전화항응치료시일충유효적치료방법.
Objective To investigate the expression of tissue factor and explore its clinical significances in pulmonary artery after acute pulmonary thromboembolism.Methods Thirty-four Japanese white rabbits (Level Ⅱ animals) were randomly (random number) assigned into four groups:group A (specimen of pulmonary artery was taken 3 hours after pulmonary embolism,n =8),group B (specimen of pulmonary artery was taken 8 hours after pulmonary embolism,n =8),group C (specimen of pulmonary artery was taken 24 hours after pulmonary embolism,n =8) and control group (pseudo-operations were carried out without injecting autologous blood clots,n =10).The animal model of pulmonary thromboembolism was established by injecting autologous blood clots into jugular vein through a 5F catheter and confirmed by digital subtraction angiography.The mRNA expression of TF in different parts of pulmonary artery was assayed by RT-PCR.The q test was utilized if there was a significant difference in a given continuous variable among three groups analyzed by ANOVA.Results The TF expression in the specimen adjacentto emboli was stable at 3 h,8 h or 24 hours after embolism.The mRNA expression of TF at 3 h and 8 h after embolism was lower in specimen taken from distal-end of morbid pulmonary artery than those adjacent to emboli.While at 24 hours after embolism,there were similar mRNA expressions in specimen either adjacent or distal to emboli.Conclusions The high expression of tissue factor in pulmonary artery tissue adjacent to emboli could lead to locally increased coagulation activity,indicating the necessity of initiating anti-coagulation treatment as soon as possible after acute pulmonary embolism.