组织因子在兔急性肺栓塞肺动脉的表达

摘要

Objective To investigate the expression of tissue factor and explore its clinical significances in pulmonary artery after acute pulmonary thromboembolism.Methods Thirty-four Japanese white rabbits (Level Ⅱ animals) were randomly (random number) assigned into four groups:group A (specimen of pulmonary artery was taken 3 hours after pulmonary embolism,n =8),group B (specimen of pulmonary artery was taken 8 hours after pulmonary embolism,n =8),group C (specimen of pulmonary artery was taken 24 hours after pulmonary embolism,n =8) and control group (pseudo-operations were carried out without injecting autologous blood clots,n =10).The animal model of pulmonary thromboembolism was established by injecting autologous blood clots into jugular vein through a 5F catheter and confirmed by digital subtraction angiography.The mRNA expression of TF in different parts of pulmonary artery was assayed by RT-PCR.The q test was utilized if there was a significant difference in a given continuous variable among three groups analyzed by ANOVA.Results The TF expression in the specimen adjacentto emboli was stable at 3 h,8 h or 24 hours after embolism.The mRNA expression of TF at 3 h and 8 h after embolism was lower in specimen taken from distal-end of morbid pulmonary artery than those adjacent to emboli.While at 24 hours after embolism,there were similar mRNA expressions in specimen either adjacent or distal to emboli.Conclusions The high expression of tissue factor in pulmonary artery tissue adjacent to emboli could lead to locally increased coagulation activity,indicating the necessity of initiating anti-coagulation treatment as soon as possible after acute pulmonary embolism.%目的 探讨急性肺栓塞肺动脉组织因子(TF)表达水平的改变及临床意义.方法 由中国医学科学院血液学研究所提供实验设备和条件.选用日本大耳白纯种家兔34只(实验动物二级,天津医科大学提供),随机(随机数字法)分为肺栓塞3h组(A组)8只,肺栓塞8h组(B组)8只,肺栓塞24h组(C组)8只,实验对照组(D组)10只.沿兔耳缘静脉取血2 mL制成血栓,沿颈静脉插入5F导管并注入血栓,建立急性肺栓塞动物模型.经数字减影检查证实肺栓塞成功.对照组不注入血栓,其余步骤与栓塞组相同.取材栓塞3、8和24 h后的栓塞部位、栓塞远端和对照组正常肺动脉组织,应用RT-PCR方法检测组织内TF mRNA的表达水平.多组均数比较用方差分析,有统计学意义后用两两比较的q检验.结果 肺栓塞3、8和24 h组,三组间栓塞部位肺动脉TF表达差异无统计学意义.栓塞3h,8h组,栓塞远端肺动脉TF表达为(0.40±0.29),(0.15 ±0.05)显著低于栓塞部位肺动脉(1.10±0.21),(0.84 ±0.22)和正常肺动脉(0.86 ±0.34)(F值为10.72,20.04,P＜0.01).栓塞24 h组,栓塞、未栓塞和正常肺动脉之间比较差异无统计学意义.结论 肺栓塞3h后栓塞远端肺动脉TF表达下降,然栓塞部位TF表达并无下降,这种局部高凝活性不利于血栓的溶解.因此针对栓塞局部的溶栓和抗凝治疗是一种有效的治疗方法.