Study On Expression Of Factors Related To Endothelial Injury And Thrombosis Induced By Intravenous Indwellingneedle

ObjectiveTo investigate markers of vascular endothelial injury:Vascular endothelial growth factor(VEGF),blood vessels,pseudo willebrand factor(vWF),the original organization type fibrinolytic enzyme activators(t-PA)expression of the situation,analyzes the relations between endothelial injury markers and thrombosis,and combined with previous studies in the blood before and after catheter D-dimer(D-D),VEGF,fibrinogen(FIB)level and the part activated clotting enzyme live time(APTT),prothrombin time(PT)and thrombin time(TT),compared with early blood vascular endothelial damage markers index trend during the process of thrombosis,To provide some experimental basis for determining the mechanism of injury factors in thrombosis induced by intravenous indwelling needle.Methods1.Review To collect specimens collected early research group,130 cases of New Zealand big-eared white rabbit ear margin vein paraffin tissue samples,divided into blank group(n=10),catheter group(were divided into normal saline group,n=30,saline mountain scopolamine intervention group,n=30,mannitol group,n=30,mannitol scopolamine intervention group,n=30),catheter indwelling time respectively.1 day,3 day,5 days at different times.At the same time,all HE pathological sections from previous studies were collected.The serial Numbers of pathological wax blocks and HE pathological sections were sorted out and corresponding to the serial Numbers of rabbits respectively.2.Method:according to the first biopsy for pathological process,then using SP immunohistochemical staining method to dyeing of slices,after staining the immunohistochemical staining results by Olympus microscope Image acquisition,finally USES the Image Pro Plus Image analysis calculated immunohistochemical positive expression of area and the area of the endothelial cells.Results:1.IHC Results(1)VEGF expression decreased after 1 day of immunohistochemical catheterization and increased after 3 days of catheterization in each catheterization group.The ratio of vefg-positive area to endothelial cell area in the mannitol intervention group at different indwelling periods was statistically significant(P<0.05).(2)The expression of vWF increased at day 1 of catheterization and decreased at day 3 and day 5 of catheterization in each catheterization group.The difference in the proportion of vWF positive area in endothelial cells in the physiological saline intervention group and mannitol intervention group in different indwelling periods was statistically significant(P<0.05).(3)The expression of t-PA:the ratio of t-PA positive area to endothelial cell area in different indwelling periods in each catheterization group was not statistically significant(P>0.05).2.Results Of Comparison Of IHC And Blood Parameters(1)The immunohistochemical expression of VEGF began to increase after 1 day of indwelling in each catheter group,and the plasma VEGF concentration increased.VEGF was indwelling in the mannitol group for 3 days and 5 days,and was indwelling in the mannitol intervention group for 3 days.There was a positive correlation between immunohistochemical VEGF and blood VEGF(r=0.723,r=0.942,r=0.818,P<0.05).After 5 days of indwelling in the mannitol group,there was a negative correlation between immunohistochemical VEGF and blood PT(r=-0.687,P<0.05).In the mannitol group,there was a positive correlation between immunohistochemical VEGF and blood APTT(r=0.806,P<0.05).Immunohistochemical VEGF and blood TT were positively correlated(r=0.692,P<0.05).After 3 days of indwelling in the mannitol group,VEGF immunohistochemical expression was decreased and plasma FIB concentration was decreased.There was a positive correlation between immunohistochemical VEGF and blood FIB(r=0.930,P<0.05).(2)VWF immunohistochemistry peaked on day 1 of catheterization in each catheterization group,and then began to decline in expression.Blood VEGF concentration increased,and the negative correlation between immunohistochemical vWF and blood VEGF was found in the saline group after 1 day of indwelling(r=-0.781,P<0.05).After 3 days of catheterization in the mannitol intervention group,blood d-d concentration decreased,which was consistent with the immunohistochemical trend of vWF,and the immunohistochemical vWF was positively correlated with blood d-d(r=0.790,P<0.05).The normal saline group received catheterization for 3 days,the blood PT was prolonged,and there was a negative correlation between immunohistochemical vWF and blood PT(r=-0.810,P<0.05).After 1 day of catheterization,blood FIB concentration increased in each catheterization group,and decreased in each catheterization group 3 days later.After 5 days of indwelling in the saline intervention group,there was a positive correlation between immunohistochemical vWF and blood FIB r=0.686,P<0.05).(3)Immunohistochemical expression of t-PA in all catheterization groups decreased on the 3rd day after catheterization except mannitol group,and decreased on the 1st day after catheterization in all other catheterization groups.Contrary to the trend of plasma VEGF,immunohistochemical t-PA was negatively correlated with blood VEGF in normal saline group at the 5th day after catheterization(r=-0.830,P<0.05).The mannitol intervention group was indwelling for 3 days,and there was a positive correlation between immunohistochemical t-PA and blood APTT(r=0.669,P<0.05).Plasma FIB concentration was increased 1 day after catheterization in each catheterization group,and decreased 3 days after catheterization.Normal saline group was kept for 1 day,and there was a positive correlation between immunohistochemical t-PA and blood FIB(r=0.713,P<0.05).Conclusion1.At the early stage of catheterization,vascular endothelial injury causes endothelial dysfunction,endothelial cell synthesis and secretion of VEGF decrease,and plasma VEGF level decreases.After thrombosis,VEGF synthesis by endothelial cells increases,and plasma VEGF is consistent with the change trend.2.When vascular endothelial injury occurs,endothelial vWF expression increases,mediating thrombosis,and vWF detection provides certain basis for judging thrombosis.3.There was a correlation between endothelial injury markers and blood coagulation and other relevant blood indicators in the process of venous indwelling needle thrombosis.