Lipo-PGE1治疗家兔肠系膜静脉血栓模型的实验研究

摘要

目的 探讨脂质微球化前列腺素E1(Lipo-PGE1)治疗家兔肠系膜静脉血栓(MVT)的可行性.方法 30只家兔随机平均分为3组,A、B两组建立MVT模型.A组(模型治疗组)采取帕肝素+Lipo-PGE1治疗,B组(模型对照组)单用帕肝素治疗,C组(非模型空白对照组)给予帕肝素治疗.分别于5个时间点,建模手术前(T1)、血栓形成后1 h(T2),以及干预治疗后2 h(T3)、4 h(T4)、6 h(T5),检测周围静脉血D-二聚体(DD)值.在实验终点观察小肠黏膜病理改变,计算改良Chiu's评分.并计算MVT溶解评分和小肠组织含水质量指数.结果 在T3～T5时间点,3组血浆DD值差异有统计学意义(P＜0.01).其中A组DD值分别为(247.5±10.5),(259.1±9.6),(273.6±11.9)ng/mL;B组为(231.9±14.1),(228.7±12.4),(224.6±12.6)ng/mL;A组高于B组.A、B两组小肠黏膜改良Chiu's评分分别为(2.00±1.15)vs(4.50±1.08)(P＜0.01),MVT溶解评分为(2.70±1.25)vs(4.40±0.97)(P＜0.01).3组小肠组织含水质量指数分别为(73.52±2.40),(83.90±2.06),(70.98±1.93)(P＜0.01).A组病理改变均优于B组.结论 Lipo-PGE1可增强家兔MVT模型体内纤溶活性,减轻受累小肠病理损害,促进MVT血栓溶解,对治疗MVT具有潜在价值.%Objective To investigate the possibility of using Lipo-PGE1 to treat acute mesenteric vein thrombosis(MVT)in a rabbit model. Methods Thirty rabbits were equally divided into three groups. Rabbit MVT models were established in group A and group B. In group A, the rabbits were treated with parnaparin ± Lipo-PGE1 , and those in group B only with parnaparin. The rabbits in group C(control group of no-MVT-model)were treated with parnaparin. The D-dimer levels from the peripheral vein were measured at five time points: before surgery,l h after MVT,and 2.4,6 h after the treatment,named T1, -T5, respectively. The pathologic changes in mucosa of small intestine were observed at the end of the experiment and the scores according to the Chiu-Park Scale were calculated. At the same time the MVT-thrombolysis Scale and the index of hydrated quality of the small intestine were calculated too. Results At the time points of T3 to T5, ,there was significant difference in the D-dimer levels among groups A,B,C(P＜0. 01). At T3 to T5 , the D-dimer levels in group A were (247. 5±10. 5) , (259. 1±9. 6) and (273. 6± 11. 9) ng/mL separately, which were higher than in group B[(231. 9± l4. l) , (228. 7±12. 4) , (224. 6±12. 6) ng/mL separatelyl. At the end of the experiment,the scores of ChiuPark Scale in groups A and group B were (2. 00±1. 15) and (4. 50±1. 08) respectively(P＜0. 01). The scores of the MVT-thrombolysis Scale in groups A and B were (2. 70±1. 25) and (4. 40±0. 97) respectively(P＜0. 01). The indexes of hydrated quality of the small intestine in groups A,B,C were (73. 52 ± 2. 40) .(83. 90±2. 06) and (70. 98± 1. 93) respectively ( P ＜ 0. 01). The pathologic changes in group A were milder than in group B. Conclusion In the rabbit MVT models,LipoPGE1 could enhance the thrombolysis activity,alleviate the pathologic lesions of the suffered small intestine and accelerate thrombolysis of MVT.