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目的 探讨葛根素对急性肺血栓栓塞溶栓治疗后再灌注损伤的影响及作用机制。方法 2 4只日本大耳白兔 ,随机分为假手术组 (S组 )、单纯溶栓组 (T组 )、葛根素组 (Pur组 ) ,经右心导管注入条柱状自体血栓 ,心导管法监测血流动力学 ,制备急性肺血栓栓塞实验模型。测定栓塞前、栓塞后2h、溶栓后 2h、4h血浆中超氧化物歧化酶 (SOD)、丙二醛(MDA)的含量 ;术毕肺组织行病理及电镜观察。结果 ①T组和Pur组在溶栓开始后 1h ,PAMP即显著下降 (P <0 0 1) ;在溶栓开始后 1hPur组PAMP即明显低于T组 (P<0 0 5 )。②在栓塞后 2h、溶栓后 2h、4h时 ,T组和Pur组血浆SOD活力均明显低于栓塞前 (P <0 0 5 ) ,而MDA含量在栓塞后 2h无明显变化 ,在溶栓后 2h、4h才开始明显升高 (P <0 0 5 ) ;与T组同期比较 ,Pur组在溶栓后 2h、4h血浆SOD活力和MDA含量分别有明显升高和下降 (P <0 0 5 ,P <0 0 1)。③组织病理及超微结构研究显示 ,Pur组血管内皮细胞和肺泡上皮细胞损伤较T组明显减轻。结论 葛根素对急性肺血栓栓塞溶栓后再灌注损伤有保护作用 ,其机制可能与其抗氧化损害的作用有关。
Objective To investigate the effect and mechanism of puerarin on reperfusion injury after thrombolysis in acute pulmonary thromboembolism. Methods 24 Japanese white rabbits were randomly divided into sham operation group (S group), simple thrombolysis group (T group) and puerarin group (Pur group). The right heart catheter was used to inject columnar autologous thrombus. Methods Blood flow dynamics were monitored and an experimental model of acute pulmonary thromboembolism was prepared. The contents of superoxide dismutase (SOD) and malondialdehyde (MDA) in plasma before embolization, 2h after embolization, 2h and 4h after thrombolysis were measured. Pathological changes and electron microscopy were performed after the operation. Results 1T group and Pur group had a significant decrease in PAMP 1 h after thrombolysis (P 0 01), and 1 h after initiation of thrombolysis, PAMP was significantly lower than T group (P 0 05). 2 At 2h after embolization and 2h and 4h after thrombolysis, plasma SOD activity in T group and Pur group was significantly lower than that before embolization (P < 0.05), but MDA content did not change significantly after 2h after embolization. After 2h and 4h, it began to increase significantly (P < 0.05). Compared with the T group, the plasma SOD activity and MDA content in the Pur group were significantly increased and decreased at 2h and 4h after thrombolysis (P <0. 5, P <0 0 1). 3 Histopathological and ultrastructural studies showed that the damage of vascular endothelial cells and alveolar epithelial cells in the Pur group was significantly less than that in the T group. Conclusion Puerarin has a protective effect against acute thromboembolism and reperfusion injury in acute pulmonary thromboembolism. Its mechanism may be related to the effect of antioxidative damage.