| Background and purpose: pulmonary thromboembolism(PTE)is a common and potentially life-threatening disorder and continues to be responsible for substantial morbidity and mortality. For a long time, PTE has been considered as a rare disease, and so the diagnosis and treatment of PTE were neglected by medical society in china , which resulted in a lower rate of discovery of PTE. Actually PTE is not a rare disease. In recent years statistical data from some Chinese hospitals prove that morbidity and morbidity proportion of PTE have been increasing apparently. In some countries of Europe and America, Investigation of epidemiology accounts for this common disorder, such as 600,000 individuals diagnosed as deep venous thrombosis (DVT)-PTE each year in the United States. It is estimated that as many as 100, 000 cases are discovered each year in France and the number of hospitalisations with PTE is 65,000 each year in British, and at least 60,000 in Italy.Recent data show that 50,000-200,000 individuals die each year as a result of PTE in the US, and PTE is estimated to the third most common cause of death in the US each year .It is confirmed that the mortality of PTE is approximately 25%~30% if it is untreated.Conversely,if the patients were diagnosed and treated in time, mortality will reduces to 2%-8%.In addition, PTE is characterized from slight complication to sudden death, and clinical manifestations caused by thromboembolic episodes are so varied that PTE is often misdiagnosed. Furthermore, PTE is an unique disease as ittakes specific symptoms. However, 67% PTE patients are diagnosed by autopsy, and false positive rate is 63%, no more than 9% individuals with PTE are diagnosed correctly before they died. In conclusion, it is very important to improve levels of diagnosis and treatment of PTE.As far as acute PTE is concerned, pulmonary vascular resistance being raised is because of both mechanical obstruction and factors associated with nerve and body fluid. For example, ET-1 inducing bronchoconstriction and pulmonary vasoconstriction is raised and then other vasodilatory substances including atrial naturetic peptide (ANP) are released in response to ET-1. The relationship between change of plasma ANP and acute PTE was not reported before. To compare plasma levels of ANP in experimental and contraol groups continuously explores the value of ANP in diagnosis and treatment of acute PTE.Materials and Methods: (l)Thirty rabbits were randomed to either PTE group (n=15) or control (n=15) group. (2) Acute PTE models of rabbits were established with injection of autologous blood clots (0.04g/kg) stabilized in temperature controlled (70 癈) water for ten minutes to the femoral vein. Then the plasma level of NAP was examined by radioimmunoassay. Moreover, pulmonary embolism (PE) Was explored at dissection and on microscopic examination after PTE. (3) The data was analysed by software SPSS 10.0 t-test to compare difference between groups. P value 0.05 was considered as statistically significant.Results: 1. The plasma levels of ANP in the early phase of PTE group were significantly higher than that in control group (P<0.05).2.The plasma levels of ANP after PTE were significantly higher than that before PTE (P0.05).3. In the late phase of PTE, the plasma levels of ANP in PTE group declined to normal levels, comparing with control group, and there is no significant difference(P>0.05).Conclusions:1 .ANP, as a vasodilatory factor is involved with mechanism of PTE especially in the early phase of acute PTE.2. The levels of ANP in plasma plays a sensitive marker used to observe conditions and seriousness of PTE. |
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