清醒羊血浆PAF在低氧性肺动脉高压产生及逆转中的变化

本实验复制清醒羊低氧性肺动脉高压模型,观察肺动脉高压发生发展及逆转过程中血浆内源性血小板活化因子（ｐｌａｔｅｌｅｔａｃｔｉｖａｔｉｎｇｆａｃｔｏｒ,ＰＡＦ）的动态变化。结果表明：（１）低氧４ｄ引起低氧血症,导致肺血管收缩,形成肺动脉高压;停止低氧后可逆转;（２）开始低氧,血中内源性ＰＡＦ升高,但低氧时间延长血浆中ＰＡＦ却不随肺动脉压升高相应增加;（３）停止低氧,血浆ＰＡＦ不随肺动脉高压的逆转而相应降低。上述结果表明血浆ＰＡＦ的变化与肺动脉高压无关。提示血中内源性ＰＡＦ不介导清醒羊低氧性肺血管收缩导致的肺动脉高压。     

慢性低氧性肺动脉高压鼠原代培养肺动脉平滑肌细胞内钙的检定

用共聚焦激光扫描显微镜观察经Ｆｌｕｏ－３／ＡＭ负荷的慢性低氧性肺动脉高压（ＨＰＨ）大鼠原代培养的肺动脉平滑肌细胞（ＰＡＳＭＣ）的形态与内游离Ｃａ２＋浓度的动态变化。结果表明：原代培养的（ＨＰＨ）大鼠的ＰＡＳＭＣ与正常大鼠相比,①细胞内游离Ｃａ２＋浓度增加,但其收缩性减弱;②随培养日数增加,咖啡因（Ｃａｆｅｉｎ）所致的细胞内储钙池－肌浆网的Ｃａ２＋释放作用逐渐减弱,直至消失;③血管紧张素Ⅱ（ＡＴ－Ⅱ）升高细胞内钙作用明显增强;④部分呈大红色细胞对多种缩血管物质敏感性增强。结果提示,ＨＰＨ大鼠的ＰＡＳＭＣ的内钙明显增加,其调节机制处于紊乱状态。     

PAF对肺内小动脉平滑肌细胞TXA_2，PGI_2乃Ca~（2＋）－ATPase的影响

本工作采用分离培养家兔肺内小动脉平滑肌细胞（ＰＡＳＭＣｓ），观察了外源性血小板活化因子（ｐｌａｔｅｌｅｔａｃｔｉｖａｔｉｎｇｆａｃｔｏｒ，ＰＡＦ）、ＢＮ５２０２１（ＰＡＦ受体拮抗剂）、吲哚美辛、维拉帕米对ＰＡＳＭＣｓ产生血栓素Ａ_２（ＴｘＡ_２）、前列环素（ＰＧＩ_２）及对细胞膜Ｃａ~（２＋）－ＡＴＰａｓｅ活力的影响。结果表明：（１）基础状态下ＰＡＳＭＣｓ存在花生四烯酸（ＡＡ）代谢。（２）外源性ＰＡＦ通过受体后途径激活环加氧酶促进ＡＡ代谢致ＴＸＡ_２及ＰＧＩ－２增加，ＴＸＡ_２／ＰＧＩ_２比值无明显变化。（３）外源性ＰＡＦ能直接抑制Ｃａ~（２＋）－ＡＴＰａｓｅ活力。（４）维拉帕米可逆转ＰＡＦ抑制ＰＡＳＭＣｓ膜Ｃａ~（２＋）－ＡＴＰａｓｅ活力的效应。     

外源性肺表面活性物质替代治疗对烟雾吸入所致肺组织细胞损害的影响

目的：探讨使用外源性肺表面活性物质（ＰＳ）治疗能否减轻烟雾吸入所致肺组织细胞损害。方法：Ｗｉｓｔａｒ大鼠随机分为５组：Ⅰ组,正常对照;Ⅱ组,烟雾吸入;Ⅲ组,烟雾＋ＰＳ＋机械通气（ＭＶ）;Ⅳ组,烟雾＋盐水＋ＭＶ;Ⅴ组,烟雾＋ＭＶ,伤后５ｍｉｎ经气管导管注入ＰＳ（１００ｍｇ／ｋｇ）或等量盐水,ＭＶ４ｈ,观察２４ｈ,检测动脉血气、肺水量、支气管肺泡灌洗液（ＢＡＬＦ）中白细胞分类计数及乳酸脱氢酶（ＬＤＨ）、血管紧张素转换酶（ＡＣＥ）和碱性磷酸酶（ＡＫＰ）活性、胎盘型碱性磷酸酶（ＰＬＡＰ）含量、肺泡壁纤维成分含量及病理检查等。结果：Ⅱ组伤后发生呼吸衰竭、肺水肿及肺部急性炎症反应,ＢＡＬＦ中ＬＤＨ、ＡＫＰ、ＡＣＥ和ＰＬＡＰ水平均明显升高,肺泡壁纤维成分含量显著减少。Ⅲ组血气较Ⅱ组明显改善,但ＢＡＬＦ中各酶水平、肺泡壁纤维成分含量及肺部炎症、水肿等无显著减轻。Ⅳ、Ⅴ组治疗无效。结论：烟雾吸入伤早期外源性ＰＳ治疗能一定程度改善呼吸功能,但对肺组织细胞损害无明显保护作用,不能减轻继发性炎症反应和急性肺水肿     

牛磺酸调节缺氧性肺、脑血管反应的机理研究

本实验从磷脂酶Ａ＿２（ＰＬＡ＿２）、前列腺素（ＰＧｓ）、白三烯（ＬＴｓ）和过氧化脂质（ＬＰＯ）方面探讨了牛磺酸调节肺、脑血管对急、慢性缺氧反应的机制。急性缺氧时狗出肺与出脑血中ＬＰＯ增加,ＰＬＡ,活性有升高趋势,但出脑与出肺（入脑）血相比无显著性差异。出肺与出脑血中ＬＴＣ＿４、ＴＸＢ＿２、６－Ｋｅｔｏ－ＰＧＦ＿（１ａ）及ＴＸＢ＿２／６－Ｋｅｔｏ－ＰＧＦ＿（１ａ）比值均升高。慢性缺氧大鼠肺、脑组织中ＰＬＡ＿２活性均升高。牛磺酸增加缺氧时６－Ｋｅｔｏ－ＰＧＦ＿（１ａ）,减弱其它变化。提示牛磺酸对缺氧性肺缩血管反应的调节作用可能与降低缺氧时ＰＬＡ＿２活性,抑制脂质过氧化和ＬＴＣ＿４、ＴＸＡ＿２生成,降低ＴＸＡ＿２／ＰＧＩ＿２比值有关;而牛磺酸减弱缺氧性脑舒血管反应不是直接通过上述变化起作用的。     

低氧对肺动脉内皮细胞PDGF—B链释放及平滑肌细胞生长的影响

应用蛋白ｄｏｔｂｌｏｔ技术检测了低氧内皮细胞条件培养液（ＨＥＣＣＭ）和常氧内皮细胞条件培养液（ＮＥＣＣＭ）内ＰＤＧＦ相对含量,并利用［３Ｈ］－ＴｄＲ掺入法和流式细胞术观察了ＨＥＣＣＭ和ＮＥＣＣＭ及加入特异ＰＤＧＦ抗体对肺动脉平滑肌细胞（ＰＡＳＭＣ）生长的影响。结果表明,ＨＥＣＣＭ中的ＰＤＧＦ含量明显高于ＮＥＣＣＭ;ＨＥＣＣＭ能明显增强ＰＡＳＭＣ内ＤＮＡ合成,促进ＰＡＳＭＣ从Ｇｏ／Ｇ１期进入Ｓ期;当预先加入ＰＤＧＦ－Ｂ链抗体时,则会明显地抑制ＨＥＣＣＭ对ＰＡＳＭＣ的ＤＮＡ合成,阻止ＰＡＳＭＣ从Ｇｏ／Ｇ１期进入Ｓ期。结果提示,低氧时ＰＡＳＭＣ增殖与肺动脉内皮细胞分泌释放ＰＤＧＦ增加有关     

低氧、血管紧张素Ⅱ对肺内小动脉平滑肌细胞膜Ca2 ┐ATPase活力的影响

本课题观察了低氧及血管紧张素Ⅱ（ａｎｇｉｏｔｅｎｓｉｎⅡ,ＡｎｇⅡ）对分离培养家兔肺内小动脉平滑肌细胞（ＰＡＳＭ－Ｃｓ）膜Ｃａ２＋－ＡＴＰａｓｅ活力的影响,同时用钙通道阻断剂维拉帕米（ｖｅｒａｐａｍｉｌ,ＶＰ）进行干预,进一步了解细胞内钙与Ｃａ２＋－ＡＴＰａｓｅ活力的关系。结果表明：ＰＡＳＭＣｓ膜Ｃａ２＋－ＡＴＰａｓｅ活力对低氧具有短暂的耐受性,随低氧时间延长,Ｃａ２＋－ＡＴＰａｓｅ活力呈时间依赖性抑制;低氧、ＡＮＧⅡ均能抑制Ｃａ２＋－ＡＴＰａｓｅ活力（Ｐ＜０．０１）低氧＋ＡⅡ对Ｃａ２＋－ＡＴＰａｓｅ活力的抑制具叠加效应（Ｐ＜０．０５）;ＶＰ可逆转低氧、ＡｎｇⅡ、低氧＋ＡｎｇⅡ对Ｃａ２＋－ＡＴＰａｓｅ活力的抑制（Ｐ＜０．０１）。结果提示：低氧,ＡＮＧⅡ可通过抑制肺血管平滑肌细胞膜Ｃａ２＋－ＡＴＰａｓｅ活力而可能削弱肺血管平滑肌舒张功能也可能是低氧性肺动脉高压（ＨＰＨ）形成的原因之一。     

一氧化氮对急、慢性缺氧大鼠血流动力学及缺氧性肺血管收缩反应的影响

观察了吸入０．００４％的一氧化氮（ＮＯ）对急、慢性缺氧大鼠血流动力学、缺氧性肺血管收缩反应（ＨＰＶ）、血气及高铁血红蛋白（ＭｅｔＨｂ）的影响。结果表明：（１）常氧吸入ＮＯ时能明显降低慢性缺氧大鼠肺动脉平均压（Ｐｐａ）和肺血管阻力（ＰＶＲ）,但对正常大鼠的Ｐｐａ和ＰＶＲ无明显影响;（２）慢性缺氧大鼠急性缺氧时ＨＰＶ较正常大鼠弱,吸入ＮＯ不但降低两者的急性缺氧肺动脉高压,且完全逆转两者的ＨＰＶ;（３）吸入ＮＯ对急、慢性缺氧大鼠体循环血流动力学、血气及ＭｅｔＨｂ含量无明显影响。提示吸入ＮＯ能选择性降低急、慢性缺氧性肺动脉高压,且逆转ＨＰＶ。     

肺血管EDNO及其合酶在大鼠低氧性肺动脉高压形成中的作用

本研究观察了低氧对大鼠肺组织和血管内皮一氧化氮合酶（ＮＯＳ）活性及内皮衍生一氧化氮（ＥＤＮＯ）依赖性舒张反应的影响,以及ＮＯＳ抑制剂（Ｌ－ＮＡＭＥ）对常氧和低氧大鼠肺组织和血管内皮ＮＯＳ活性及颈、肺动脉血压（ＣＡＰｓ、ｍＰＡＰ）的作用。结果表明常氧大鼠肺泡内无肌性血管内皮未见ＮＯＳ活性,其肺血管床对ＥＤＮＯ依赖性舒血管物质ＢＫ没有反应,注射Ｌ－ＮＡＭＥ后大鼠ｍＰＡＰ略有降低,ＣＡＰｓ有所升高。低氧大鼠肺泡内无肌性血管内皮显示ＮＯＳ活性,对ＢＫ的ＥＤＮＯ依赖性舒张反应呈剂量依赖性增大,注射Ｌ－ＮＡＭＥ使低氧大鼠ｍＰＡＰ显著降低（Ｐ＜０．０１）,ＣＡＰｓ显著升高（Ｐ＜０．０５）。提示肺血管ＥＤＮＯ及其合酶在维持正常成年大鼠肺循环低压低阻中的生理作用值得进一步探讨;低氧引起肺血管内皮ｅｃＮＯＳ活性增加和ＥＤＮＯ生成增多可能起到限制肺动脉压过度升高的调制作用,也可能对肺血管内皮产生毒性作用,反而促进肺动脉高压的发生和发展。     

粉防己碱抑制血管平滑肌细胞增殖及对HSP70和p53表达的影响

目的：观察粉防己碱（Ｔｅｔ）对ＶＳＭＣ增殖的作用及对热应激蛋白７０ｋｄ（ＨＳＰ７０）及其ｍＲＮＡ和抑癌基因ｐ５３ｍＲＮＡ的影响。方法：用内皮素建立培养的血管平滑肌细胞增殖模型。采用氚－胸腺嘧啶核苷（［３Ｈ］ＴｄＲ）掺入法流式细胞术,Ｗｅｓｔｅｒｎ及Ｎｏｒｔｈｅｒｎｂｌｏｔ杂交方法。结果：Ｔｅｔ能逆转内皮素所致的［３Ｈ］ＴｄＲ掺入量增多（Ｐ＜０．０１）,阻止血管平滑肌细胞由静止期（Ｇ０／Ｇ１期）进入ＤＮＡ合成期（Ｓ期）和有丝分裂期（Ｇ２／Ｍ期）,并能逆转内皮素引起的ＨＳＰ７０及ｍＲＮＡ表达增强（Ｐ＜０．０１或Ｐ＜０．０５）,ｐ５３抑癌基因ｍＲＮＡ表达减弱（Ｐ＜０．０５）。结论：Ｔｅｔ能抑制血管平滑肌细胞增殖,与ＨＳＰ７０及ｐ５３的调控有关     

磷脂酶A2活力与急性缺氧性肺动脉高压关系的探讨

通过动物实验探讨磷脂酶Ａ２及相关炎性介质在急性缺氧性肺动脉高压形成中的作用。３０只ＳＤ大鼠随机分为三组;正常对照组,缺氧组及缺氧加地塞米松组。均测定肺动脉压;缺氧３０ｍｉｎ后,取静脉血肺组织测定ＰＬＡ２活力,血小板活化因子,前列腺素Ｅ２,血栓素Ｂ２。     

乙醇对狗急性低氧性肺血管收缩反应的影响—白三烯的作用

本实验采用急性胃内灌注乙醇的方法,观察了乙醇对狗血流动力学和低氧性肺血管收缩反应(HPV)的影响,同时探讨了白三烯(LTs)在其中的作用。结果表明:①给乙醇(0.5g/kg)后肺血管阻力(PVR)和平均肺动脉压(_(pa))显著升高,用脂氧化酶抑制剂特异性地抑制白三烯的合成后,乙醇引起的PVR和_(pa)升高不显著,表明LTs介导乙醇引起的肺血管收缩反应。②给乙醇后HPV显著增强.急性低氧性肺动脉高压明显加重,用脂氧化酶抑制剂特异性地抑制LTs的合成后.乙醇增强HPV的效应被抑制.表明LTs在乙醇增强HPV的效应中起介导作用。实验结果提示饮酒不利于低氧性肺动脉高压、肺心病和高原性心脏病的防治。     

PAF antagonists inhibit pulmonary vascular remodeling induced by hypobaric hypoxia in rats.

Chronic hypoxia causes pulmonary hypertension and pulmonary vascular remodeling in rats. Because platelet-activating factor (PAF) levels increase in lung lavage fluid and in plasma from chronically hypoxic rats, we examined the effect of two specific, structurally unrelated PAF antagonists, WEB 2170 and BN 50739, on hypoxia-induced pulmonary vascular remodeling. Treatment with either agent reduced hypoxia-induced pulmonary hypertension and right ventricular hypertrophy at 3 wk of hypoxic exposure (simulated altitude 5,100 m) but did not affect cobalt (CoCl2)-induced pulmonary hypertension. The PAF antagonists had no effect on the hematocrit of normoxic or chronically hypoxic rats or CoCl2-treated rats. Hypoxia-induced pulmonary hypertension was associated with an increase in the vessel wall thickness of the muscular arteries and reduction in the number of peripheral arterioles. In WEB 2170-treated rats, these changes were significantly less severe than those observed in untreated chronically hypoxic rats. PAF receptor blockade had no acute hemodynamic effects; i.e., it did not affect pulmonary arterial pressure or cardiac output nor did it affect the magnitude of acute hypoxic pulmonary vasoconstriction in awake normoxic or chronically hypoxic rats. Isolated lungs from chronically hypoxic rats showed a pressor response to the chemotactic tripeptide N-formyl-Met-Leu-Phe (fMLP) and an increase in the number of leukocytes lavaged from the pulmonary circulation. In vivo treatment with WEB 2170 significantly reduced the fMLP-induced pressor response compared with that observed in isolated lungs from untreated chronically hypoxic rats. These results suggest that PAF contributes to the development of chronic pulmonary hypertension induced by chronic hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS)     

感觉神经肽与支气管对肺动脉缺氧反应的影响

豚鼠离体肺动脉用辣椒素（Ｃａｐｓａｉｃｉｎ）耗竭感觉神经肽（ＳＮＰ）后,缺氧性收缩反应（ＨＰＶ）显著增高（Ｐ＜０．０１）。套有带完整上皮支气管的肺动脉的ＨＰＶ显著弱于不套或套有去上皮支气管肺动脉的ＨＰＶ（Ｐ＜０．０５）;支气管与肺动脉同时用Ｃａｐ处理后,此差异消失;只有外套的支气管先用Ｃａｐ预处理时,肺动脉ＨＰＶ仍显著强于溶剂预处理的对照组（Ｐ＜０．０５）;套有去上皮支气管的肺动脉缺氧反应显著强于不套支气管的肺动脉。结果提示：肺动脉Ｃ－感觉神经所释放的ＳＮＰ在肺动脉缺氧反应中具调节作用;支气管上皮层可释放舒血管物质调节ＨＰＶ,此物质与ＳＮＰ密切相关;支气管还可能释放缩血管物质,介导ＨＰＶ。     

缺氧性肺动脉高压大鼠肺腺泡内动脉肌化与内皮结构变化的关系

利用右心导管术、光镜、微机辅助测量及透射电镜,综合观察分析了不同时间减压缺氧(5000m高度)对大鼠肺腺泡内动脉(IAA)内皮结构和肌化的影响及与肺动脉高压(PH)的关系。发现:(1)缺氧24h,IAA即有明显肌化;随缺氧时间延长,ф<50μm的外周血管肌化百分率持续增加,与肺动脉压增高及右室肥厚密切相关。揭示IAA肌化为PH形成的重要原因。(2缺氧24h,IAA内皮是显著胞内水肿;缺氧7d,出现内皮下水肿,内皮增生、肥厚;缺氧14d,内皮下水肿严重,内弹力层大部消失,内皮增生、肥厚继续加重;缺氧21及40d,内皮下水肿减轻,但增生、肥厚更重。结合肺动脉压及IAA肌化变化分析,提示因不同缺氧时间段IAA内皮结构不同程度的变化,其参与导致动脉肌化的机制有所不同。     

Platelet-activating factor antagonists increase vascular reactivity in perfused rat lungs

Platelet-activating factor (PAF) administered to the pulmonary circulation in low dose (nanogram) has vasodilatory properties. Therefore, we investigated whether endogenous PAF plays a role in the control of tone in the pulmonary circulation. The PAF receptor antagonists, SRI 63-441 (2.6 X 10(-4) M) and L659,989 (1 X 10(-5) M), were the major investigative tools. In isolated perfused rat lungs, both agents caused a persistent increase in base-line perfusion pressure (Ppa), potentiated angiotensin II (ANG II) vasoconstriction, and potentiated hypoxic vasoconstriction (HPV). This potentiation of ANG II and HPV was found to be independent of circulating blood elements. Vasodilation in the presence of PAF blockade was also impaired. The combination of cyclooxygenase inhibition and PAF receptor blockade had an additive effect on ANG II vasoconstriction but did not cause more potentiation of HPV than achieved with PAF antagonism alone. In vivo, SRI 63-441 (10 mg/kg) caused only a transient increase in base-line Ppa without altering ANG II and hypoxic vasoconstriction. These findings support a vasodilatory role for endogenous PAF in the pulmonary circulation.     

川芎嗪对慢性缺氧大鼠肺动脉和主动脉的离体舒张作用

用生物测定法观察了川芎嗪对慢性缺氧大鼠肺动脉和主动脉环的舒张效应,并与乙酰胆碱的舒血管作用进行了比较。结果表明:川芎嗪对慢性缺氧大鼠肺动脉和主动脉的舒张作用均与平原组无明显差异。慢性缺氧明显减低了乙酰胆碱诱发的肺动脉内皮依赖性舒张反应,但不影响川芎嗪对肺血管的舒张作用。提示川芎嗪对肺血管的舒张作用不依赖于内皮。川芎嗪对肺动脉的舒张作用明显大于体动脉。这些特性有利于川芎嗪对肺动脉高压的治疗。     

Role of platelet-activating factor in the ovine heparin-protamine reaction.

Platelet-activating factor (PAF) infusion into sheep, as well as protamine reversal of heparin anticoagulation, causes thromboxane release into plasma, pulmonary hypertension, hypoxemia, and leukopenia. We investigated the possible role of PAF in the heparin-protamine reaction. Intravenous protamine was administered to neutralize heparin anticoagulation in five awake sheep and caused an increase of mean pulmonary arterial pressure from 16.6 +/- 1 (SE) mmHg at base-line to 47 +/- 9 mmHg at 1 min after protamine injection (P < 0.01) because of a 4.5-fold increase of pulmonary vascular resistance. This neutralization reaction induced a 25% reduction of circulating leukocyte count and arterial PO2. Undetectable blood levels of PAF were measured by bioassay and high-performance liquid chromatography during these heparin-protamine reactions. Infusion of BN 52021 (20 mg/kg), a PAF receptor antagonist, before rechallenging the same sheep with heparin and then protamine did not reduce the level of peak pulmonary hypertension or the degree of hypoxemia and leukopenia. We conclude that the leukopenia and thromboxane-mediated pulmonary vasoconstriction occurring after rapid intravascular formation of heparin-protamine complexes in sheep are not due to the release of PAF.