溶栓前后肺血栓栓塞症大鼠肺血管内皮细胞ICAM-1及Ps的表达

EXPRESSION OF ICAM-1 AND P-SELECTIN IN PULMONARY VASCULAR ENDOTHELIAL CELLS OF RAT WITH PTE

目的观察溶栓前后肺血栓栓塞症(pulmonarythromboembolism,PTE)大鼠肺血管内皮细胞上细胞间粘附分子-1(intercellularadhesion-1,ICAM-1),P-选择素(P-selectin,Ps)的变化,以此探讨溶栓治疗的影响。方法采用自体血栓回输法建立PTE模型,随机分为对照组、模型组、溶栓组。各组动物在栓塞后1、3、24、72、120h5个时间段分别处死,进行病理切片,免疫组化和原位杂交的方法检测肺血管内皮细胞上ICAM-1和Ps的蛋白及mRNA的变化。结果肺栓塞后病理可见肺动脉血栓形成,炎性反应明显。肺血管内皮上ICAM-1蛋白及mRNA表达在栓塞后3h开始增高(P<0·01),而Ps蛋白及mRNA表达在栓塞后1h开始增高(P<0·01)。溶栓治疗后,栓塞、出血、萎缩减轻,但炎性反应有所加重,肺血管内皮上ICAM-1和Ps的水平再次升高(P<0·01)。结论细胞间粘附分子-1与P-选择素均参与了大鼠肺血栓栓塞症的发病过程,溶栓治疗并未改善肺组织的炎性损伤。

Objective To observe the expression of intercellular adhesion molecule-1 （ICAM-1） and P-selectin （Ps） in the pulmonary vascular endothelial cells of rats with acute pulmonary thromboembolism, and to explore the effect of thromblytic therapy on the process of inflammation. Methods Rats were randomly divided into control group, model group, and urokinase （UK） -treated group. The pulmonary thromboembolism （PTE） model was established by intravenous injection of auto-blood clots. All rats were sacrificed 1 , 3 , 24, 72 or 120 hours after treatment, 1ml vascular blood was withdrawn from each animal for blood gas analysis. The expression of ICAM-1 and P-selectin in the vascular endothelial cells was evaluated by immunohistochemical method, and ICAM-1 mRNA and Ps rnRNA were detected by in situ hybridization. Results Notable embolism in pulmonary arteries and inflammatory cell infiltration around alveoli could be found by microscopy. The expression of ICAM-1 was elevated quickly at 3 hour after embolization （P〈0.01）. The expression of Ps became higher at 1 hour after embolization than that before embolization （P〈0.01）. UK treatment alleviated embolism and hemorrhages but aggravated inflammatory - reaction, and the expression of ICAM-1 and Ps in the vascular endothelial cells was raised again. Conclusion The cell adhesion molecule plays an important role in PTE. Thromblytic therapy can not improve the inflammatory reaction of acute PTE.