连花清瘟对急性肺栓塞家兔的疗效

doi:10.3969/j.issn.2095-9400.2020.06.010

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摘要目的：探讨连花清瘟（LHQW）对急性肺栓塞（APE）家兔炎症细胞因子的影响及治疗效果。方法：将家兔随机分为假手术组、模型组和LHQW组，每组10只。模型组和LHQW组将自体血凝块反复注入主肺动脉建立APE模型。模型建立后，LHQW组予LHQW 0.42 g/kg灌胃；假手术组和模型组予等量0.9% NaCl溶液灌胃。比较3组间不同时间点动脉血气、血流动力学和炎症因子指标变化。结果：与模型组比，LHQW治疗后1和8 h的PaO2显著升高（P＜0.05）。与模型组比，LHQW组在治疗后1、2、4和8 h的MPAP显著降低（P＜0.05）；而与模型组比，LHQW组在治疗后1、2、4和8 h的MAP显著升高（P＜0.05）。LHQW组在治疗后1、2、4和8 h的cTnI、NT-proBNP、TNF-α、IL-6和IL-1β均较模型组显著降低（P＜0.05）。LHQW组的肺栓塞组织中性粒细胞积累较模型组显著减少（P＜0.05）。结论：LHQW有助于降低APE家兔的机体炎症水平，改善动脉血气和血流动力学指标，并减轻心肌损伤。

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关键词 ：连花清瘟, 急性肺栓塞, 炎症细胞因子, 动脉血气, 血流动力学

Abstract：Objective: To investigate the effect of Lianhuaqingwen (LHQW) on reducing inflammatory cytokines in a rabbit model of acute pulmonary embolism (APE). Methods: Rabbits were randomly divided into sham operation group, model group and LHQW group, with 10 rabbits in each group. In the model group and the LHQW group autologous blood clots were repeatedly injected into the main pulmonary artery of the rabbits to establish the APE model. After the model was established, the LHQW group was intragastrically administered with LHQW 0.42 g/kg; the sham operation group and the model group were intragastrically administered with an equal amount of 0.9% NaCl solution. The changes in arterial blood gas, hemodynamics and inflammatory factors at different time points were compared among the three groups. Results: Compared with the model group, PaO2 was significantly higher at 1 and 8 hours post LHQW treatment (P<0.05). Compared with the model group, the MPAP in the LHQW group was significantly reduced at 1, 2, 4, and 8 hours after treatment (P<0.05); compared with the model group, the MAP in the LHQW group was significantly increased at 1, 2, 4, and 8 hours after treatment (P<0.05). The levels of cTnI, NT-proBNP, TNF-α, IL-6 and IL-1β in the LHQW group were significantly lower than those in the model group at 1, 2, 4 and 8 hours after treatment (P<0.05). HE staining showed that the accumulation of neutrophils in the pulmonary embolism tissue of the LHQW group was significantly lower than that of the model group (274.6±96.0 vs. 111.5±38.1, P=0.003). Conclusion: LHQW is helpful in reducing the level of systemic inflammation and myocardial injury while improving arterial blood gas and hemodynamics in APE rabbits. It has therapeutic effect on APE to a certain extent.

Key words： Lianhuaqingwen acute pulmonary embolism inflammatory cytokines arterial blood gas hemodynamics

收稿日期: 2019-08-03

基金资助:温州市科技计划项目（Y20180533）。

作者简介: 陈之力（1979-），男，浙江平阳人，副主任医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/10.3969/j.issn.2095-9400.2020.06.010 或 https://xb.wmu.edu.cn/CN/Y2020/V50/I6/480

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