动脉微栓塞中纤维蛋白成分的组织病理分析

Histopathology analysis of microemboli after thrombolysis

目的观察动脉微栓塞中的纤维蛋白成分,为纤溶治疗微栓塞提供理论依据。方法取体重(180±10)g的成年雄性SD大鼠30只,按照随机数字表法将动物分为正常对照组及微栓塞形成后5、30、60和90min组。以大鼠提睾肌动脉为靶血管,先用光化学法造成大血栓,再用葡激酶溶栓,造成微栓塞。用免疫组化法检测动脉微栓塞中纤维蛋白溶解标志物组织型纤溶酶原激活物(tPA)及其抑制剂(PAI)的阳性指数。结果微栓塞Masson染色病理组织切片上能见到动脉微栓塞中团块状均质、绿染的纤维蛋白结构。同时,免疫组化切片上可见tPA、PAI。5、30、60和90min组tPA免疫组化阳性指数逐渐减少(P均<0.01),PAI免疫组化阳性指数逐渐增多(P均<0.01)。结论纤维蛋白是动脉微栓塞的重要组成部分。随着动脉微栓塞时间的延长,纤维蛋白含量增加。

Objective To observe the changes in fibrin of microemboli in micro-embolism soon after thrombolysis, in order to provide a theoretical basis for microthrombolytic therapy. Methods Thirty adult male SD rats weighing （180±10）g were randomized into five groups： 5, 30, 60 and 90 minutes groups after microthrombolization and the control group. Rat cremasteric artery was embolized with photochemical method, and microthomboli were produced after thrombolysis by staphylokinase. The levels of tissue plasminogen activator （t -PA） and tissue plasminogen activator inhibitor （PAI） were immunohistochemically determined, and taken as the markers of fibrin dissolution. Results Fibrin was observed in pathologic sections as well as fibrinolytic markers t - PA and PAI in immunohistochemical sections. The levels of t - PA were found to be reduced while that of PAI increased gradually with passage of time. Conclusion Fibrin is one of the main constituents of microthromboli soon after thrombolysis. The content of fibrous emboli increases after microembolization with the passage of time. Thrombolysis plays an important role in the treatment of ＂no reflow phenomenon＂.