兔急性肺栓塞面积与血流动力学的相关性研究

Correlation Study Between Obstructive Area of Rabbit with Acute Pulmonary Embolism and Hemodynamic Changes

[目的]制备不同梗阻面积的兔急性肺栓塞模型，探讨肺栓塞面积与血流动力学变化的相关性。[方法]通过介入方法经导管注入自体血栓选择性栓塞肺动脉，建立不同栓塞面积的兔急性肺栓塞模型；比较栓前、栓后15min，30min，1h，2h血流动力学指标变化，同时观察心脏超声影像学变化。[结果]自体血栓均按要求阻塞相应肺动脉，肺栓塞形成后心输出量下降，肺动脉压力显著增高，并在1h，2h达到峰值，各血流动力学指标随肺栓塞面积增大而变化更显著。[结论]此急性肺栓塞动物模型制作方法确切可行，具有可重复性。肺栓塞导致血流动力学及左右心室功能紊乱，栓塞面积与其损害程度呈正相关，并严重影响预后。

[Objective] To study the correlation of hemodynamic instability and the area of pulmonary vascular obstruction by establishing animal models of acute pulmonary embolism （APE） of different obstructive areas. [Methods] With cardiac catheterization, autologous thrombus was injected respectively into right total pulmonary artery and right lower pulmonary artery to establish animal models of different embolism areas. Before and at 15 min, 30 min, and 1 h, 2 h after embolization, the hemodynamic changes were compared. The continuous transesophageal echocardi0graphic imaging was also observed. [Results] Anatomy showed thrombus obstructed corresponding pulmonary artery. After injection of thrombus, cardiac output dropped rapidly, pulmonary artery pressure rose significantly, and all parameters attained to extremum at 1 h and 2 h. Compared between the animals of different embolism area, wider anatomic region obstructed, more serious he- modynamies changed. [Conclusion] The establishment of APE model is feasible and repeatable. APE can produce significant hemodynamic instability and biventricular cardiac dysfunction. It seems reasonable to propose that hemodynamic injury and the prognosis in APE are directly related to the area of pulmonary vascular obstruction.