肺栓塞后栓塞区肺组织病理学和碱性成纤维细胞生长因子水平的变化及意义

An experimental study on the repair mechanism after pulmonary embolism

目的 了解肺动脉栓塞后机体修复过程中肺组织内小血管密度及碱性成纤维细胞生长因子 (bFGF)的变化情况。方法 选取 8只健康犬 ,通过向肺动脉内注射明胶海绵建立周围性肺栓塞模型。模型建立后第 1、7、14和 2 8天分别处死 2只犬 ,取栓塞侧肺组织和非栓塞侧肺组织进行苏木精 伊红 (HE)染色和免疫组化染色 ,观察上述不同时间栓塞侧肺组织的病理学变化、bFGF的表达情况以及小血管密度的改变 ,并与非栓塞侧肺组织进行对比。结果 (1)肺栓塞后第 1天 ,栓塞区肺泡腔和肺泡间隔可见液体和细胞渗出 ;栓塞后第 7天 ,渗出的液体和细胞进一步增加 ;栓塞后第 14天渗出的液体和细胞大部分已被吸收 ;栓塞后第 2 8天 ,渗出的液体和细胞完全被吸收 ,组织恢复正常。 (2 )栓塞后第 1、7、14天 ,栓塞区bFGF的表达水平与对侧非栓塞区相比显著提高 (χ2 分别为 4 4 335、71 911、84 4 6 0 ,P均 <0 0 1) ,栓塞后第 2 8天两者相比差异无显著性 (χ2 =2 96 1,P >0 0 5 )。 (3)栓塞后第 1天 ,栓塞区肺组织内小血管密度为 (4 5 6± 0 5 0 )根 /视野 ,与对侧非栓塞区的 (4 11± 0 76 )相比差异无显著性 (P >0 0 5 ) ;栓塞后第 7、14、2 8天 ,栓塞区肺组织内小血管密度 [分别为 (10 17± 1 0 8)、(10 5 4± 0 93)、(

Objective To study the role of basic fibroblast growth factor(bFGF) and small vascular density in the repair mechanism after pulmonary embolism(PE). Methods After peripheral pulmonary arteries had been embolized, 8 dogs were killed 1, 7,14,and 28 days after embolization.One piece of tissue was taken from the region embolized and unembolized respectively, then HE staining and immunohistochemical staining were performed. The pathological change of the lung, changes of small vascular density and expression of bFGF were observed, and were compared between regions embolized and unembolized at different time points. Results (1) The course of pathological change during the pulmonary embolism period. (2) The bFGF was increased from 1st day to 14th day after PE(1st day: χ 2=44.335, 7th day:χ 2=71.911, 14th day: χ 2=84.460;P<0.01), and decreased to normal on 28th day (χ 2=2.961, P>05). (3) Small vascular density in embolized region (4.56±0.50) showed no statistical difference from that of unembolized region (4.11±0.76) on 1st day (P>0.05), while it (7th day: 10.17±1.08,14th day:10.54±0.93,28th day:11.47±1.11) was significantly higher than that of unembolized region (7th day: 6.17±0.90, 14th day: 7.55±1.19,28th day: 7.03±1.24) after embolized 7,14,28 days (P<0.05). Conclusions After PE, with increased expression of bFGF in embolized region, the formation of collateral arteries between pulmonary artery system and bronchial artery system is promoted, and absorption of the transuded blood cells and fluid is accelerated. This mechanism may be important in prevent pulmonary infarction.