CAJ | 학술논문

目的探讨自体心包条带制作肺动脉狭窄动物模型的可行性.方法 8头小型猪分别接受左侧第3肋间开胸,取自体心包条,用生理盐水浸泡30 min后,环缩左肺动脉至原始直径的30％～ 40％,术后1个月正中开胸,应用心导管及造影检查测量左肺动脉环缩术后跨狭窄段收缩压差及狭窄处肺动脉内径,行肺动脉支架置入术,3个月后取材行组织病理检查.结果左肺动脉环缩后即刻,左肺动脉内径从(16.0±0.4) mm减少到(6.4±0.2)mm(P＜0.01),而术中环缩后跨狭窄段压差为35(18 ～52) mm Hg(中位数,极值,1mm Hg=0.133 kPa),环缩术后1个月与环缩后即时结果比较,动脉内径及跨狭窄段压差,差异均无统计学意义(P＞0.05).环缩术后8只小型猪均存活,未出现环缩带松脱、断裂等并发症,也未出现左肺动脉发育不良或动脉闭锁.病理结果显示环缩处肺动脉未见钙化灶,周围肺动脉壁组织大致正常.结论在动物肺动脉狭窄模型制作中,应用自体心包环缩带是切实可行的.
목적 탐토자체심포조대제작폐동맥협착동물모형적가행성.방법 8두소형저분별접수좌측제3륵간개흉,취자체심포조,용생리염수침포30 min후,배축좌폐동맥지원시직경적30％～ 40％,술후1개월정중개흉,응용심도관급조영검사측량좌폐동맥배축술후과협착단수축압차급협착처폐동맥내경,행폐동맥지가치입술,3개월후취재행조직병리검사.결과 좌폐동맥배축후즉각,좌폐동맥내경종(16.0±0.4) mm감소도(6.4±0.2)mm(P＜0.01),이술중배축후과협착단압차위35(18 ～52) mm Hg(중위수,겁치,1mm Hg=0.133 kPa),배축술후1개월여배축후즉시결과비교,동맥내경급과협착단압차,차이균무통계학의의(P＞0.05).배축술후8지소형저균존활,미출현배축대송탈、단렬등병발증,야미출현좌폐동맥발육불량혹동맥폐쇄.병리결과현시배축처폐동맥미견개화조,주위폐동맥벽조직대치정상.결론 재동물폐동맥협착모형제작중,응용자체심포배축대시절실가행적.
Objective To evaluate the effectiveness of autologous pericardium applied to pulmonary artery banding in a swine model.Methods In a swine model,pulmonary artery stenosis was created by autologous pericardium which made the left pulmonary artery banded to 30％-40％ of its original diameter.Animals underwent right heart catheterization and angiography 4 weeks postoperatively,and balloon-expandable'stents were implanted through right ventricular outflow tract.The animals were sacrificed at 12th week following stenting and microscopic evaluation for histologic changes was made.Results Pulmonary artery banding was performed on 8 swines.The lumen diameter was decreased from (16.0 ± 0.4) mm to (6.4 ± 0.2 )mm ( P ＜ 0.01 ),while the gradient inereased from median (range) 0 mm Hg to 35 ( 18-52 )mm Hg (1 mm Hg =0.133 kPa,P ＜0.01 ) following banding.One month later,the models were all survived.Compared to the instant result after banding,there was no significant difference in the lumen diameter ( P ＞ 0.05) or the gradient (P ＞ 0.05),and there was no banding dislodged and also no animal with severe left pulmonary artery hypoplasia or atresia.Conclusion Autologous pericardium as a banding to create an experimental pulmonary artery stenosis model appears safe and effective.