【摘要】 目的　探讨兔急性肺血栓栓塞症 (PTE) 时血浆和肺泡灌洗液中TNF-α, IL -8和 IL- 10的水平及尿激酶的影响。方法　采用自体血栓回输法建立兔急性PTE模型。随机分为对照组、治疗组和模型组。ELISA方法检测血浆和肺泡灌洗液中细胞因子 (CK) 水平, 术毕行病理分析。结果　栓塞后上述 CK水平明显升高, 治疗后再次升高。病理检查可见, 栓塞后肺动脉内血栓形成, 组织萎缩、出血、炎性反应明显。治疗后栓塞、出血、萎缩减轻, 但炎性反应有所加重。结论　急性PTE后CK在引起急性肺损伤中起重要作用, 溶栓治疗可以改善 PTE的供血, 但短期内对肺组织的炎性损伤没有帮助, 可能与缺血再灌注损伤有关。因此, 在急性 PTE溶栓治疗的同时抗炎治疗也不容忽视。更多还原

【Abstract】 Objective To explore the levels of tumor necrosis factor-α (TNF-α),interleukin-8 (IL-8) and interleukin-10 (IL-10) in blood plasma and bronchial alveolar lavage fluid (BALF) in acute pulmonary thromboembolism (PTE) and the effect of urokinase (UK). Methods PTE model of rabbits was established by intravenous injection of autologous blood clots. Rabbits were randomly divided into the control (CTL) group,treatment group and model group. By enzyme-linked immunosorbent assay (ELISA),the levels of cytokines (CK) in blood plasma and BALF were measured. At the end of operation,the rabbits were sacrificed and lung removed for histopathologic examination. Results After embolization,the levels of CK were increased obviously. After thromblytic,the levels were raised again. Histopathologic examination revealed that in the model group,notable embolism,atrophy,hemorrhages and inflammatory reaction were seen in lung tissues. Whereas,in the treatment group,embolism,hemorrhages and atrophy were alleviated,but inflammatory reaction aggravated to some extent. Conclusion In the acute PTE,pro-inflammatory CK may play an important role in acute lung injuries. Thromblytic therapy can improve blood supply of PTE,but doesn’t benefit to the inflammatory damage to lung tissues in a short-term,which is contributed to the ischemia-reperfusion injury. Thus,thromblytic and ant-inflammatory therapy are same important in acute PTE.更多还原