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Changes of Fibrinolysis and Their Relationship with pulmonary artery pressures in Neonates with Lung Diseases

中国当代儿科杂志 2002年第4期4卷 339-341页

作者： LI Juan, LIU Xue Yan, LIU Yun Ying, WEI Ke Lun(Department of Pediatrics, Second Clinical College, China Medical University, Shenyang 110004, China)

Objective To study changes in plasma fibrinolysis and their relationship with pulmonary artery pressures in neonates with lung diseases. Methods Plasma activities of the tissue plasminogen activator (TPA) and tissue plasminogen activator inhibitor (PAI) were measured by chromogenic substrate methods in 27 newborns with lung diseases [10 with the respiratory distress syndrome (RDS), 12 with the meconium aspiration syndrome (MAS) and 5 with pneumonia] and in 25 normal newborns (controls). The ratio of the time of peak velocity (TPV) to the right ventricular ejection time (RVET) was determined using an Aloka SSD650 ultrasound system incorporating pulse waves to evaluate pulmonary artery pressures. Results PAI activity was significantly higher in infants with lung diseases [( 9.3 ± 4.1 ) AU×10 -1 /ml] than in the controls [( 5.5 ± 3.0 ) AU×10 -1 /ml] (Ppulmonary artery pressures appeared to be involved in the fibrinolytic dysfunction in the infants with lung diseases. In 10 infants who developed pulmonary hemorrhage, TPA activity [( 1.8 ± 0.7 ) IU×10 -1 /ml)] and platelet counts [( 98 ±39)×10 9/L] in the acute phase of injury were significantly lower than those recorded during the recovery stage [( 3.7 ± 1.7 ) IU×10 -1 /ml and (180±30)×10 9/L, respectively] (Ppulmonary hypertension, endothelial cell injury results in a lower release of TPA and increased PAI activity.

关键词： Fibrinolysis pulmonary artery pressure Lung disease Newborn

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Effects of thrombolytic drugs and a selective endothelin-1 receptor antagonist on acute pulmonary thromboembolism in dogs

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Chinese Medical Journal 2010年第4期123卷 395-400页

作者： HAN Li LI Qing-yun ZHOU Ling WANG Xi BAO Zhi-yao LI Min WAN Huan-ying SHI Guo-chao Department of Respiratory Medicine Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200025 China

Background It has been shown that neurohumoral factors other than mechanical obstruction are involved in the pathophysiology of acute pulmonary thromboembolism （APTE）. The aim of this study was to investigate the effects of thrombolytic drugs, a selective endothelin-1 receptor （ET-1 R） antagonist alone or their combination on APTE in a canine model. Methods Twenty dogs were randomly assigned to five groups： sham, model, urokinase （UK）, BQ123, and combination （UK plus BQ123）. The dogs in the sham group underwent sham surgery. APTE was induced in the other four groups by intravenous injection of autologous blood clots. Dogs in the UK, BQ123 and combination groups received UK, BQ123 （a selective ET-1R antagonist）, or UK plus BQ123, respectively. The dogs in the model group were given saline. Mean pulmonary artery pressure （mPAP）, serum concentrations of ET-1, thromboxane （TXB2）, and tumor necrosis factor （TNF）-α were determined at different time points following the induction of APTE. Results UK and BQ123 alone markedly decreased mPAP in APTE. By comparison, the reduction was more significant in the combination group. Compared with the sham group （（-0.90±0.61） mmHg）, mPAP increased by （7.44±1.04）, （3.42±1.12） and （1.14±0.55） mmHg in the model group, UK alone and BQ123 alone groups, respectively, and decreased by （2.24±0.67） mmHg in the combination group （P 〈0.01）. Serum ET-1 concentrations in the BQ123 and combination groups were （52.95±8.53） and （74.42±10.27） pg/ml, respectively, and were significantly lower than those in the model and UK groups （（84.56±7.44） and （97.66±8.31） pg/ml respectively; P 〈0.01）. Serum TNF-α concentrations were significantly lower in the BQ123 group than in the model, UK and combination groups （P 〈0.05）. Conclusions Our results indicate that the selective ET-1R antagonist BQ123 not only reduces the increase of mPAP and serum ET-1 level, but also inhibits the production of TNF-α, and attenuates the local inflammatory response induced by APTE.

关键词： acute pulmonary thromboembolism thrombolytics endothelin-1 receptor antagonist pulmonary artery pressure

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Long-term outcome of correction of tetralogy of Fallot in 56 adult patients

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Chinese Medical Journal 2013年第19期126卷 3675-3679页

作者： ZHENG Da-wei SHAO Guo-feng FENG Qiang NI Yi-ming Department of Cardiothoracic Surgery the First Affiliated HospitalZhejiang University School of Medicine Hangzhou Zhejiang310003 China Department of Cardiothoracic Surgery Ningbo Medical CentreLihuili Hospital Ningbo Zhejiang 315041 China

Background Although most patients with tetralogy of Fallot undergo radical repair during infancy and childhood,patients that remain undiagnosed and untreated until adulthood can still be *** study aimed to evaluate longterm outcomes of adult patients with tetralogy of Fallot who were treated surgically,and to determine the predictors of postoperative pulmonary *** Fifty-six adult patients underwent complete surgical ***-three patients （76.8%） required a transannular ***,diastolic,and mean pressure in the main pulmonary artery were measured after *** The early mortality rate was 3.6%.The 16-year survival rate was （84.4±11.5）%.Late echocardiography revealed 41 patients with transannular patch who had pulmonary regurgitation,consisting of mild pulmonary regurgitation in 28 patients,moderate in eight,and severe regurgitation in five *** addition,there was right ventricular outflow tract stenosis in nine patients,moderate/severe tricuspid valve regurgitation in seven,and residual ventricular septal defect in *** regression analysis demonstrated that the mean pulmonary pressure measured just after repair predicted late pulmonary *** The long-term survival of surgically treated adult patients with tetralogy of Fallot is *** mean pressure 〉20 mmHg in the main pulmonary artery measured right after surgical repair may be a feasible reference to time the reconstruction of the pulmonary valve.

关键词： tetralogy of Fallot pulmonary regurgitation pulmonary artery pressure congenital heart disease

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多巴胺对内毒素休克犬肺动脉压力的影响

多巴胺对内毒素休克犬肺动脉压力的影响

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作者：陶炳东中国医科大学

学位级别：硕士

目的通过观察多巴胺对内毒素休克时犬肺动脉压力(PAP)的影响,对多巴胺用于内毒素休克治疗的价值做进一步评价。方法选择健康雄性杂种犬20只,随机分为4组,每组5只。以静脉注射内毒素脂多糖(LPS)1 mg/kg制备内毒素休克模型,2 h后分别以生... 详细信息

目的通过观察多巴胺对内毒素休克时犬肺动脉压力(PAP)的影响,对多巴胺用于内毒素休克治疗的价值做进一步评价。方法选择健康雄性杂种犬20只,随机分为4组,每组5只。以静脉注射内毒素脂多糖(LPS)1 mg/kg制备内毒素休克模型,2 h后分别以生理盐水5 ml/h(对照组),多巴胺5、10、20 ug/kg/min(分别记为D5组、D10组、D20组)静脉泵入。股动脉及开胸行肺动穿刺测压。记录给药0、5、10、30、60及120min时平均动脉压(MAP)及平均肺动脉压(MPAP)。结果不同浓度的多巴胺均能升高MAP和MPAP,与对照组比较差异均有统计学意义(P＜0.05或P＜0.01);且D10组、D20组较D5组MAP、MPAP升高幅度显著(P＜0.05或P＜0.01)。多巴胺各组MAP/MPAP比值均高于对照组,以高剂量组显著(P＜0.05或P＜0.01)。结论犬内毒素休克MAP剧降同时PAP基本无变化;静脉泵入多巴胺后,MAP升高同时PAP在休克前水平的基础上升高,休克后PAP不变和给多巴胺后升高的原因是肺末梢循环阻力增加。

关键词： septic shock dopamine pulmonary artery pressure

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