实验性急性肺栓塞及溶栓疗法与动脉血浆内皮素水平变化

Changes of Arterial Plasma Endothelin Levels Induced by Acute Pulmonary Embolism and Thrombolytic Therapy

探讨内皮素在急性血栓栓塞性肺动脉高压中的作用和溶栓疗法对肺动脉释放内皮素的影响。１４只杂种犬，自体血栓注入法建立急性肺栓塞模型。随机分为溶栓组和对照组，溶栓组７只犬给予尿激酶２００００Ｕ／ｋｇ，１００ｍｌ液体稀释后３０ｍｉｎ静脉滴入；对照组同期输入等量的生理盐水。分别于注栓前、溶栓前（对照组同期）、溶栓后（对照组同期）血液动力学测定，采动脉血备测血浆内皮素水平。溶栓组犬静注尿激酶３０ｍｉｎ后，肺动脉压力和肺血管阻力显著性下降，动脉血浆内皮素水平于１．５ｈ开始显著性升高；对照组犬栓塞后４ｈ内肺动脉压力和肺血管阻力无显著变化，内皮素水平亦无显著性改变。说明内皮素可能与急性血栓栓塞性肺动脉高压的形成有关，动脉血浆内皮素水平的增加可能是血管再通的一个标志。

To investigate the role played by endothelin in acute thromboembolic pulmonary hypertension and the effects of thrombolytic therapy on endothelin released from pulmonary arterioles,we established an animal model of acute pulmonary embolism by intravenous infusion of autologous blood clot.Fourteen model dogs were randomized to either urokinaestreated (UK,n=7) or control (CTL,n=7) group.Haemodynamic monitoring and arterial plasma endothelin determinations were conducted periodically.Urokinase,20 000U/kg over 30min,was given to seven UK dogs intravenously,whereas the CTL dogs received only 100ml intravenous saline solution.It was demonstrated that plasma endothelin of UK treated dogs increased progressively with the decrease of pulmonary artery pressure and pulmonary vascular resistance.No significant changes in pulmonary artery and pulmonary vascular resistance occurred and plasma endothelin levels remained unchanged in CTL dogs with time.In conclusion,endothelin may play a very important role in the formation of acute thromboembolic pulmonary hypertension,and the increased endothelin levels of arterial plasma may be a marker of pulmonary revascularization.