Objective To explore the change of serum angiotensin1 converting enzyme in acute pulmonary embolism(PE).Methods Twenty-four SD rats were randomized into three groups:control group(n=8),embolism for 24 h group(n=8) and embolism for 1 week group(n=8).Embolism rats were injected with medical gelfoam microspheres via jugular vein to establish the PE model and the control rats were injected with saline.The rats were sacrificed after 1 week for control group and 24 h and 1 week for embolism groups.Arterial blood was collected at the time of sacrifice for blood gas analysis and serum angiotensin-converting enzyme determination.Lung tissue sections were made and stained with HE to observe the embolism of pulmonary arteries.Results The mean pulmonary pressures of control group,embolism for 24 h group and embolism for 1 week group were(14.2±4.1) mm Hg,(26.1±7.5) mm Hg and(26.1±6.8) mm Hg respectively.The arterial O2 partial pressures were(94.1±8.8) mm Hg,(80.5±5.8) mm Hg and(80.4±13.8) mm Hg respectively(P0.05).The levels of serum angiotensin1 converting enzyme were(30.5±7.2) U/L,(53.5±15.9) U/L,(45.8±17.4) U/L respectively.After 24 h of embolism,pulmonary arteries were shown to be embolized by gelfoam,which was resolved partly after 1 week.Conclusions The level of serum angiotensin1 converting enzyme increased significantly in acute pulmonary embolism,the extent of which may be related to the extent of obstruction of the pulmonary vascular bed.

由于急性肺栓塞右室功能不全患者病死率较高,因而超声心动图检查被作为肺栓塞危险分层和预后评估的手段.由于许多医院不具备床旁超声心动图的检测条件,寻找一个能简单评估肺栓塞危险分层和预后的指标十分必要.本研究观察了急性肺栓塞患者血浆肌钙蛋白(cTnI)、肌酸激酶(CK-MB)、肌酸激酶同工酶(CK)的水平,探讨了其对预后的评估价值.