CAJ | 학술논문

目的：利用猪胰弹力酶诱导法制作类似人颅内动脉瘤特点的兔颈内动脉梭形动脉瘤模型。方法采用新西兰大白兔25只，随机分为正常对照组5只、0．9%氯化钠溶液对照组5只和实验组15只，实验组再随机分为3亚组（7、14和21 d组），每组5只。应用猪胰弹性蛋白酶消化兔右侧颈总动脉建立梭形动脉瘤模型，7、14、21 d时分别行DSA检测、HE染色、弹力纤维染色观察模型动物的影像学和病理学变化。结果 DSA造影显示正常对照组血管直径（1．64±0．17）mm；0．9%氯化钠溶液对照组血管直径（1．66±0．24）mm。7 d组动脉瘤长径和宽径分别为（19．33±1．65）mm 和（2．86±0．21）mm；14 d组分别为（19．66±1．18）mm和（3．95±0．54）mm；21 d组分别为（19．84±0．82）mm和（4．03±0．95）mm。病理学观察发现7 d组梭形动脉瘤模型内弹力膜断裂，中膜平滑肌结构絮乱，细胞形态扭曲；14 d组梭形动脉瘤模型瘤腔内膜逐渐增生稳定；21 d组梭形动脉瘤模型瘤颈与瘤腔交界处结构的变化明显。弹力纤维染色显示7 d组梭形动脉瘤模型弹力层明显变薄；14 d组从交界处始弹力层逐渐变薄；21 d组变薄的弹力层基本稳定。结论利用简单外科手术方法结合猪胰弹性蛋白酶消化局部血管壁，可以建立形态学与人颅内动脉瘤相似的梭形动脉瘤模型，且动脉瘤模型与人颅内动脉瘤病理结构相似。
목적：이용저이탄력매유도법제작유사인로내동맥류특점적토경내동맥사형동맥류모형。방법채용신서란대백토25지，수궤분위정상대조조5지、0．9%록화납용액대조조5지화실험조15지，실험조재수궤분위3아조（7、14화21 d조），매조5지。응용저이탄성단백매소화토우측경총동맥건립사형동맥류모형，7、14、21 d시분별행DSA검측、HE염색、탄력섬유염색관찰모형동물적영상학화병이학변화。결과 DSA조영현시정상대조조혈관직경（1．64±0．17）mm；0．9%록화납용액대조조혈관직경（1．66±0．24）mm。7 d조동맥류장경화관경분별위（19．33±1．65）mm 화（2．86±0．21）mm；14 d조분별위（19．66±1．18）mm화（3．95±0．54）mm；21 d조분별위（19．84±0．82）mm화（4．03±0．95）mm。병이학관찰발현7 d조사형동맥류모형내탄력막단렬，중막평활기결구서란，세포형태뉴곡；14 d조사형동맥류모형류강내막축점증생은정；21 d조사형동맥류모형류경여류강교계처결구적변화명현。탄력섬유염색현시7 d조사형동맥류모형탄력층명현변박；14 d조종교계처시탄력층축점변박；21 d조변박적탄력층기본은정。결론이용간단외과수술방법결합저이탄성단백매소화국부혈관벽，가이건립형태학여인로내동맥류상사적사형동맥류모형，차동맥류모형여인로내동맥류병리결구상사。
Objective To establish the carotid fusiform aneurysm model in rabbits carrying similar characteristics of human intracranial aneurysms by using induction method with porcine pancreatic elastase. Methods Twenty-five New Zealand white rabbits were randomly divided into normal control group (n=5), saline control group (n = 5) and study group (n = 15). The rabbits of the study group were randomly and equally subdivided into 7-day subgroup, 14-day subgroup and 21-day subgroup. By using induction method with porcine pancreatic elastase to digest right common carotid the fusiform aneurysm model was established in all the rabbits of the study group. DSA examination , HE staining and elastic fiber staining pathologic examination were carried out at 7, 14 and 21 days after the procedure to observe the imaging and pathologic changes of the fusiform aneurysm models. Results DSA angiography showed that the mean vascular diameters of the normal control group and the saline control group were (1.64 ± 0.17) mm and (1.66 ± 0.24) mm respectively. The mean length and width of the fusiform aneurysm of the 7-day subgroup, 14-day subgroup and 21-day subgroup were (19.33 ± 1.65) mm and (2.86 ± 0.21) mm, (19.66 ± 1.18) mm and (3.95 ± 0.54) mm, and (19.84 ± 0.82) mm and (4.03 ± 0.95) mm, respectively. Pathologically, rupture of internal elastic membrane, disordered structure of tunica media smooth muscle and distortion of cell shape were observed in the rabbits of 7-day subgroup. Gradually stabilized aneurysmal lumen intimal hyperplasia was seen in the rabbits of 14-day subgroup. Remarkable structure changes at the aneurysmal neck-cavity junction were found in the rabbits of 21-day subgroup. Elastic fiber staining demonstrated that strikingly thinned elastic layer was observed in the rabbits of 7-day subgroup, gradually thinning elastic layer at the aneurysmal neck-cavity junction was seen in the rabbits of 14-day subgroup, and the thinned elastic layer became stable in the rabbits of 21-day subgroup. Conclusion Using simple surgical method combined with porcine pancreatic elastase to digest vascular wall, carotid fusiform aneurysm models can be reliably established in New Zealand white rabbits which carry similar morphologic and pathologic characteristics of human intracranial aneurysms.