CAJ | 학술논문

　　目的：观察猪胰弹性酶快速诱导建立兔囊状动脉瘤模型的形态学改变和早期病理学变化，探讨动脉瘤的创伤修复机制，为动脉瘤的治疗寻找新的切入点。方法：应用猪胰弹性酶消化兔右侧颈总动脉起始部建立动脉瘤模型，3 d、7 d、21 d灌注取出动脉瘤组织，采用病理学、免疫组织化学、脑血管造影技术研究该模型的影像学和病理学变化。结果：病理学观察发现动脉瘤顶部均有红血栓形成，血管内皮细胞消失，瘤壁完全缺失弹力层，载瘤动脉的弹力层在动脉瘤颈部突然消失，动脉瘤内膜逐渐增生，但仍缺乏弹力层，平滑肌细胞和胶原纤维增生明显。免疫组织化学均显示内膜Von Willebrand因子（ vWF ）染色阴性。对照组动物均形成动脉残端，动脉残腔内无或少量血栓，血管壁结构完整。造影显示21 d 动脉瘤长径（6．40±1．62） mm，宽径（4．41±1．15）mm，瘤颈宽（5．30±2．51） mm，载瘤动脉直径（3．99±1．59） mm。结论：通过简单外科手术方法结合弹力酶消化局部血管壁，可以建立病理学和形态学上与人颅内动脉瘤相似的动脉瘤模型。动脉瘤模型早期存在一定的自身修复机制，内膜逐渐增生，以平滑肌细胞和胶原纤维增生为主，未见弹力纤维和内皮细胞增生修复。
　　목적：관찰저이탄성매쾌속유도건립토낭상동맥류모형적형태학개변화조기병이학변화，탐토동맥류적창상수복궤제，위동맥류적치료심조신적절입점。방법：응용저이탄성매소화토우측경총동맥기시부건립동맥류모형，3 d、7 d、21 d관주취출동맥류조직，채용병이학、면역조직화학、뇌혈관조영기술연구해모형적영상학화병이학변화。결과：병이학관찰발현동맥류정부균유홍혈전형성，혈관내피세포소실，류벽완전결실탄력층，재류동맥적탄력층재동맥류경부돌연소실，동맥류내막축점증생，단잉결핍탄력층，평활기세포화효원섬유증생명현。면역조직화학균현시내막Von Willebrand인자（ vWF ）염색음성。대조조동물균형성동맥잔단，동맥잔강내무혹소량혈전，혈관벽결구완정。조영현시21 d 동맥류장경（6．40±1．62） mm，관경（4．41±1．15）mm，류경관（5．30±2．51） mm，재류동맥직경（3．99±1．59） mm。결론：통과간단외과수술방법결합탄력매소화국부혈관벽，가이건립병이학화형태학상여인로내동맥류상사적동맥류모형。동맥류모형조기존재일정적자신수복궤제，내막축점증생，이평활기세포화효원섬유증생위주，미견탄력섬유화내피세포증생수복。
Objective:To create the elastase-induced saccular aneurysm model in rabbits and observe the morphological and early pathological changes of the tumor for examining the lesion and repair mechanisms of aneurysm to find a breakthrough with tumor treatment .Methods:Experi-mental aneurysm models were developed in rabbits using porcine pancre-atic elastase digestion at the origin of right common carotid artery ( RC-CA).The animals were sacrificed at day 3,7 and 21,respectively,to re-move the aneurysms for examining the in vitro imaging and pathological changes on immunohistochemistry and digital subtraction angiography ( DSA) basis.Results:Pathologic findings revealed formation of red throm-bi at the dome of all aneurysms, disappearance of vascular endothelial cells,complete deletion of the aneurysm wall and abrupt termination of the elastic layer of the parent artery at the level of the aneurysm neck . Although the layer of the tunica intima tended to be proliferative ,yet the elastic lamina was still absent and hyperplasyed collagen fiber and smooth muscle cells were predominant .Immunohistochemistry exposed total nega-tive staining for von Willebrand factor(vWF).The control group demon -strated entire residual of RCCA with a few or absence of thrombosis and integrated structure of vessel wall .DSA examination at day 21 exhibited the mean height of aneurysms by (6.40 ±1.62) mm,width by(4.41 ± 1.15)mm,neck diameter by (5.30 ±2.51)mm and parent vessel diame-ter by (3.99 ±1.59) mm.Conclusion:Combination of simple surgery and porcine pancreatic elastase digestion of the origin of right common ca-rotid artery can develop an aneurysm model mimicking human intracranial aneurysms in pathology and morphology.Self-repair mechanisms and tuni-ca intima proliferation to a certain degree occurs in the early stage after model creation, and the proliferation seems dominant in smooth muscle cells and collagen fibers.No elastic fibers and endothelial cell proliferative repair occur.