实验性肺栓塞溶栓血管紧张素Ⅰ和血管紧张素Ⅱ变化的意义

Changes and clinical significance of angiotensin Ⅰ and angiotensin Ⅱ in experimental pulmonary thromboembolism in rabbits

目的 探讨兔实验性肺栓塞症（PTE）溶栓前后血管紧张素Ⅰ（ANGⅠ）和血管紧张素Ⅱ（ANGⅡ）变化及其临床意义。方法 健康中国大耳白兔30只，按照随机数字法将实验动物分为肺栓塞组，对照组和溶栓组，每组10只。栓塞组和溶栓组自颈静脉注入自体小血凝块建立家兔急性肺栓塞模型，溶栓组从耳静脉注入尿激酶。结果 栓塞组兔的肺表面凸凹不平，有散在苍白病灶，并可见点片状出血灶，镜下肺动脉血管内可见有注入的血凝块，血管壁炎症细胞浸润及间质出血。栓塞后5d处死的家兔可见栓塞灶内有肉芽组织形成。肺栓塞后ANGⅠ 1h开始持续升高，2h达高峰；溶栓组2h后变化无显著差异；栓塞组ANGⅡ 1h明显升高并持续，与栓塞前相比均有显著差异。溶栓组1h开始升高2h达高峰，此后开始下降至与栓塞前相比无显著差异。结论 PTE兔4h内ANGⅠ和ANGⅡ有不同程度的升高，溶栓后明显降低，故PTE的溶栓或一般治疗中用拮抗剂（ACEI）或受体拮抗剂（ARB）是有益的。

Objective To study the change and clinical significance of angiotensin Ⅰ and angiotensin Ⅱ before and after experimenal pulmonary thromboembolism in rabbits. Methods Rabbits pulmonary thromboembolism models by injection of auto-blood clots into femoral vein were used to observe the change of angiotensin Ⅰ and angiotensin Ⅱ. Results Petechial and patchy hemorrhehages were observed on the surface of embolic lungs. The injected blood clots could be found by microscope. The concentration of angiotensin Ⅰand angiotensin Ⅱ in blood were significantly elevated after embolism, but angiotensln Ⅰ and angiotensin Ⅱ did not significantely elevate after administration of urokinase. Conclusions Angiotensin Ⅰ and angiotensin Ⅱ in blood vary in the concentration before and after experimential pulmonary thromboembolism and thrombolysis therapy. The administration of angiotensin-converting enzyme inhibitor （ACEⅠ） or angiotensin Ⅱ receptor block（ARB） in treatment of thromboembolism will have benefit.