目的 探讨不同剂量低分子肝素对幼年大鼠急性肺栓塞的治疗及肺动脉内膜增生抑制作用。方法 将90只 幼年SD大鼠随机分为假手术组,肺栓塞组,低、中和高剂量低分子肝素组(LLMH、MLMH和HLMH组)。 除假手术组外, 各组均制作急性肺栓塞模型,LLMH、MLMH、HLMH组在术后分别给予低分子肝素0.005、0.01、0.02 mL/kg, 2次/d皮 下注射,假手术组予生理盐水注射。各组于术后7 d、14 d和28 d检测动脉血气、肺动脉压力(mPAP)、右心室压力(RVP)、 肺动脉管壁面积/管面积、管壁厚/管外径、肺组织PDGF-B和MCP-1基因及蛋白表达,肺组织HE染色后行病理检查。结 果 28 d时,MLMH组肺组织病理改变较轻。7 d、14 d和28 d时,MLMH组大鼠PaO2低于假手术组,高于栓塞组、LLMH 组,差异均有统计学意义(P??0.05),但低于其余3组(P均 ?0.05),但低于其余3组(P均 ?0.05),但低于其余3组(P均 ?0.05)。 结论 中等剂量低分子肝素更能有效的改善大鼠急性肺栓塞和抑制肺动脉内膜增殖。
Objectives To investigate the effect of different dosages of low molecular weight heparin on acute pulmonary embolism and inhibition of pulmonary intimal hyperplasia in immature rats. Methods 90 male immature SD rats were randomly divided into five groups: sham group, pulmonary embolism group, low-low molecular heparin group (L-LMH), medium-low molecular heparin group (M-LMH) and high-low molecular heparin group (H-LMH). The model of acute pulmonary embolism was established through jugular vein injection with gel-foam solution. The rates in the L-LMH, M-LMH, H-LMH groups were treated with low molecular weight heparin by subcutaneous injection after surgery with a dosage of 0.005ml/kg, 0.01ml/kg, 0.02ml/kg, twice a day. Animals in the control group were given saline injection. Arterial blood gas, pulmonary artery pressure (mPAP), right ventricular pressure (RVP), wall area/tube area, wall thickness/tube diameter, and the expression of PDGF-B and MCP-1 at gene and protein levels in lung tissue were detected on the 7th (7d), 14th (14d) and 28th (28d) after opration. Results There were significant differences of PaO2 among 5 groups on 7d, 14d and 28d. PaO2 in group M-LMH (105.1±4.6 mm Hg) were significantly higher than that of embolization group, L-LMH, but not H-LMH group at 28d. mPAP of M-LMH group was lower than that in the other three intervention groups, but showed no significant difference compared with sham group (P?>0.05). There were significant differences of RVP on 7d and 14d. PDGF-B, MCP-1 of M-LMH group were significantly lower compared with the other three intervention groups (P?<?0.05), but showed no significant difference compared with sham group (P?>0.05). Wall area/tube area, wall thickness/tube diameter scores of M-LMH group had no significance differences compared with sham group on 28d (P?>?0.05). Conclusion Medium dose of low molecular weight heparin could ameliorate the acute pulmonary embolism and inhibit the proliferation of pulmonary arteries in rats.