CAJ | 학술논문

背景:应用左向右分流大鼠模型可以研究慢性肺血管重构在成人型先天性心脏病中的发病机制.目的:观察慢性左向右分流大鼠模型慢性肺动脉高压形成的特点.设计、时间及地点:随机对照动物实验,于2008-04/2009-04在解放军第三军医大学新桥医院动物实验中心完成.材料:4周龄SPF级纯系健康SD大鼠80只,体质量95-110 g.随机分为对照组、分流组,每组40只.自制改良聚乙烯血管连接套管,近心端内外径分别为0.6 mm和0.8 mm,远心端内外径分别为0.8 mm和1.0mm,长1.6mm.方法:分流组大鼠:行左向右分流术,运用收缩型聚乙烯血管连接器建立右颈总动脉-颈外静脉连接.对照组行假手术.手术后在第4,8,12,16周(每个时相点10只大鼠),通过血流动力学检查、病理标本制作、苏木精-伊红染色、图像分析等一系列步骤对该模型进行评价.主要观察指标:分流组和对照组大鼠右室收缩压、右心肥大比率[右室/(左室+室间隔)],各级肺小动脉相对中膜厚度改变.结果:全部实验动物存活.分流组肺循环血流量明显高于对照组(P<0.01).与对照组相比,分流12,16周右室收缩压明显增高(P<0.01),分流12,16周时右心肥大比率显著增加(P<0.01).与对照组相比,分流12周和16周组肺动脉相对中膜厚度明显增加(P<0.01).结论:左向右的持续低分流,能有效引起慢性肺血管重构,颈总动脉-颈外静脉连接建立慢性肺动脉高压模型操作简便,稳定性好,对实验动物损伤小,是研究低分流引起的慢性肺动脉高压形成的有用工具.
배경:응용좌향우분류대서모형가이연구만성폐혈관중구재성인형선천성심장병중적발병궤제.목적:관찰만성좌향우분류대서모형만성폐동맥고압형성적특점.설계、시간급지점:수궤대조동물실험,우2008-04/2009-04재해방군제삼군의대학신교의원동물실험중심완성.재료:4주령SPF급순계건강SD대서80지,체질량95-110 g.수궤분위대조조、분류조,매조40지.자제개량취을희혈관련접투관,근심단내외경분별위0.6 mm화0.8 mm,원심단내외경분별위0.8 mm화1.0mm,장1.6mm.방법:분류조대서:행좌향우분류술,운용수축형취을희혈관련접기건립우경총동맥-경외정맥련접.대조조행가수술.수술후재제4,8,12,16주(매개시상점10지대서),통과혈류동역학검사、병리표본제작、소목정-이홍염색、도상분석등일계렬보취대해모형진행평개.주요관찰지표:분류조화대조조대서우실수축압、우심비대비솔[우실/(좌실+실간격)],각급폐소동맥상대중막후도개변.결과:전부실험동물존활.분류조폐순배혈류량명현고우대조조(P<0.01).여대조조상비,분류12,16주우실수축압명현증고(P<0.01),분류12,16주시우심비대비솔현저증가(P<0.01).여대조조상비,분류12주화16주조폐동맥상대중막후도명현증가(P<0.01).결론:좌향우적지속저분류,능유효인기만성폐혈관중구,경총동맥-경외정맥련접건립만성폐동맥고압모형조작간편,은정성호,대실험동물손상소,시연구저분류인기적만성폐동맥고압형성적유용공구.
BACKGROUND: A left-to-right shunting animal model is needed to study chronic pulmonary vascular remodeling of congenital heart attachment disease in adult.OBJECTIVE: To observe the characteristics of chronic pulmonary arterial hypertension in rat models subjected to left-to-right shunting.DESIGN, TIME AND SETTING: Randomized controlled animal modeling observation was performed in Experimental Animal Center, Xinqiao Hospital, the Third Military Medical University of Chinese PLA from April 2008 to April 2009.MATERIALS: A total of 80 male inbred line healthy SD rats of specified-pathogens free class, 4 weeks old, weighing 95-110 g, were randomly assigned into control group (n=40) and shunt operation group (n=40). A shrinking polyethylene blood vessel connector (proximal part inner diameter was 0.6 mm and outer diameter was 0.8 mm, while distal part's was 0.8 mm and 1.0 mm, respectively, 1.6 mm long), was applied.METHODS: Shunt operation group underwent left-to-right shunting through right common carotid artery and external jugular vein connected by shrinking polyethylene blood vessel connector. Control group underwent sham operation. At 4, 8, 12 and 16 weeks postoperation, ten models were determined with a series in procedures: hemodynamics detection, pathological sample preparation, hematoxylin-eosin staining, imaging analysis and so on.MAIN OUTCOME MEASURES: Changes in right ventricular systolic pressure, right ventricular hypertrophy index of right ventricle to left ventricle plus interventricular septum, and relative medial wall thickness in moderate sized pulmonary arteries in rats of shunt group and control group.RESULTS: All animal were survived. The pulmonary blood flow in shunt group was significantly higher than control groups (P<0.01). Compared with control group, right ventricular systolic pressure elevated obviously and right ventricular hypertrophy index were significantly higher in shunt group at 12 and 16 weeks (P<0.01). Compared with control group, the relative medial wall thickness in pulmonary arteries also elevated obviously in shunt group at 12 and 16 weeks (P<0.01).CONCLUSION: Left-to-right continuous low-flow shunt in rats can induced right ventricle accommodated with the change of right ventricular systolic pressure and promote chronic pulmonary arterial remodeling continuously. The procedure of establishing left-to-right shunting models with common carotid artery and external jugular vein connection, is a stable tool for studying chronic pulmonary arterial hypertension induced by low flow.