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目的 :探讨管壁胶原及Ⅰ、Ⅲ型胶原变化在慢性低O2 高CO2 性肺动脉高压形成中的作用。方法 :采用透射电镜、图像分析及免疫组化等方法 ,研究四周低O2 高CO2 对大鼠肺动脉压力和管壁胶原及Ⅰ、Ⅲ型胶原的影响 ,肺动脉壁I和III型胶原的平均积分吸光度值作为Ⅰ、Ⅲ型胶原的相对含量。结果 :①低O2 高CO2 组 (B组 )大鼠肺动脉平均压 (MPAP)显著高于对照组 (P <0 .0 1) ,颈动脉平均压 (MCAP)无明显变化 (P >0 .0 5 ) ;②电镜下 ,低O2 高CO2 大鼠肺细小动脉中膜平滑肌细胞明显增生 ,面积增大 ,其间胶原纤维丰富 ,外膜纤维母细胞增生 ,胶原纤维高度密集。免疫组化发现低O2 高CO2 大鼠肺细小动脉管壁Ⅰ型胶原平均吸光度值较对照组明显增高 (P <0 .0 1) ,Ⅲ型胶原平均吸光度值两组间无明显差异 (P >0 .0 5 ) ;③低O2 高CO2 组大鼠血浆内皮素浓度较对照组明显升高(P <0 .0 1) ,血清一氧化氮 (NO)较对照组明显减低 (P <0 .0 1)。结论 :肺动脉壁的胶原含量增多 (Ⅰ型胶原增多 )与慢性低O2 高CO2 性肺动脉高压的形成以及肺动脉结构重建有关 ,一氧化氮和内皮素可能起介导作用
Objective: To explore the role of collagen and type I and type III collagen in the formation of chronic hypoxic hypercoagulable pulmonary hypertension. Methods: Transmission electron microscopy, image analysis and immunohistochemical methods were used to investigate the effects of hypoxia and hypercapnia on the pulmonary arterial pressure and collagen type I and III in rats. The mean integral absorbance of type I and III collagen in pulmonary artery wall Values as the relative content of type I, type III collagen. Results: ① The mean pulmonary arterial pressure (MPAP) of rats in hypoxic hypercapnia group (B group) was significantly higher than that in control group (P <0.01), but there was no significant change in mean arterial pressure (MCAP) 5). ② Under the electron microscope, the VSMCs of pulmonary arterioles in hypoxic hypercapnia rats proliferated significantly with an increase in area. During this period, collagen fibers were abundant, fibroblasts proliferated and collagen fibers were highly dense. Immunohistochemistry showed that the average absorbance of type Ⅰ collagen in the pulmonary arterioles wall of hypoxic hypercapnia rats was significantly higher than that of the control group (P <0.01), while there was no significant difference between the two groups (P> 0.05). ③ The plasma endothelin concentration of hypoxic hypercapnia group was significantly higher than that of control group (P <0.01), and the level of serum nitric oxide (NO) was significantly lower than that of control group (P <0. 0 1). CONCLUSIONS: Increased collagen content in the pulmonary artery wall (type I collagen) is associated with the formation of chronic hypoxic hypercapnia pulmonary hypertension and remodeling of pulmonary arteries, and nitric oxide and endothelin may play a mediating role