CAJ | 학술논문

目的评价上腔静脉(SVC)频谱在大鼠低压低氧性肺动脉高压疗效评价中的应用价值,为寻求临床PH疗效评价新方法提供实验依据.方法雄性SD大鼠50只,对照组10只,40只建立低压低氧性肺动脉高压模型,随机分为贝前列素组、西地那非组、安慰剂组和模型组各10只.3周后,模型组超声检测心脏结构,测量肺动脉峰值流速(PAVmax)、三尖瓣峰值流速(TVEmax)、SVC频谱,右心导管(RHC)测定右心室收缩压(RVSP)、肺动脉收缩压(PASP).贝前列素组、西地那非组、安慰剂组再灌喂2周后同样行超声检测并测压,相关参数进行统计学分析,取肺组织切片行HE染色.结果 RHC测压结果显示治疗后各组肺动脉收缩压(PASP)均低于模型组,差异具有统计学意义(P＜0.01);置于正常环境饲养治疗2周后,贝前列素组和西地那非组肺动脉压下降明显,与对照组比较差异无统计学意义;安慰剂组仍高于对照组,差异具有统计学意义(P＜0.05);两种药物比较,PASP差异无统计学意义.右室壁/体质量与对照组相比,各组均增大,模型组与之差异有统计学意义(P ＜0.01).模型组右侧SVC AR/S增高,治疗后各组与其相比差异有统计学意义(P＜0.01).右侧SVC AR/S与PASP明显相关(r=0.603,P=0.001);与对照组相比,各组均有不同程度的肺小动脉管壁增厚.结论右侧SVC频谱AR/S与PASP相关性良好,可用于评价大鼠低压低氧性肺动脉高压,特别是中度以上肺动脉高压的疗效.
목적 평개상강정맥(SVC)빈보재대서저압저양성폐동맥고압료효평개중적응용개치,위심구림상PH료효평개신방법제공실험의거.방법 웅성SD대서50지,대조조10지,40지건립저압저양성폐동맥고압모형,수궤분위패전렬소조、서지나비조、안위제조화모형조각10지.3주후,모형조초성검측심장결구,측량폐동맥봉치류속(PAVmax)、삼첨판봉치류속(TVEmax)、SVC빈보,우심도관(RHC)측정우심실수축압(RVSP)、폐동맥수축압(PASP).패전렬소조、서지나비조、안위제조재관위2주후동양행초성검측병측압,상관삼수진행통계학분석,취폐조직절편행HE염색.결과 RHC측압결과현시치료후각조폐동맥수축압(PASP)균저우모형조,차이구유통계학의의(P＜0.01);치우정상배경사양치료2주후,패전렬소조화서지나비조폐동맥압하강명현,여대조조비교차이무통계학의의;안위제조잉고우대조조,차이구유통계학의의(P＜0.05);량충약물비교,PASP차이무통계학의의.우실벽/체질량여대조조상비,각조균증대,모형조여지차이유통계학의의(P ＜0.01).모형조우측SVC AR/S증고,치료후각조여기상비차이유통계학의의(P＜0.01).우측SVC AR/S여PASP명현상관(r=0.603,P=0.001);여대조조상비,각조균유불동정도적폐소동맥관벽증후.결론 우측SVC빈보AR/S여PASP상관성량호,가용우평개대서저압저양성폐동맥고압,특별시중도이상폐동맥고압적료효.
Objective To explore the value of superior vena cava (SVC) Doppler spectrum in evaluation of the therapeutic effects of intermittent hypobaric hypoxia (HBHO)-induced pulmonary hypertension (PH) in rats and establish a new method for assessing pulmonary hypertension.Methods Fifty male SD rats were included.Forty of them were developed HBHO-PH and randomly divided into four groups with different manipulations:beraprost treatment group,sildenafil treatment group,placebo group and model group,with 10 rats in each group.The rest of 10 rats served as controls.Cardiac structure,pulmonary peak velocity (PAVmax),tricuspid peak velocity (TVEmax) and SVC Doppler ultrasound were performed in all rats before and after treatment for 2 weeks.Pulmonary arterial pressure was determined by the right heart catheterization.The relationship of the parameters with the pulmonary arterial pressure was analyzed.HE staining was done in lung tissues.Results Right heart catheterization showed that pulmonary artery systolic pressure (PASP) of the treatment groups were lower than that of the model group,the difference was significant(P ＜0.01).Pulmonary artery pressure decreased in varying degrees both after placed in a normal environment and after 2 weeks of treatment.PASP of the beraprost treatment group and the sildenafil treatment group decreased significantly and showed no statistical significant difference with the control group.In contrast,PASP of the placebo group was significant higher than that of control group(P ＜ 0.05).No statistically significant difference was found between the non-placebo treatment groups in PASP.Compared with the control group,the right ventricle/body weight ratio of the model group was statistically significant increased in all other groups(P ＜0.01).Right SVC AR/S ratio was well correlated with PASP (r =0.603,P =0.001).Right SVC AR/S ratio was statistically significant lower in treatment groups compared with the model group (P ＜0.01).All groups except the control group demonstrated various degrees of pulmonary arterial wall thickening.Conclusions The right SVC spectrum of AR/S correlates well with PASP and can be used to evaluate the pharmacological therapeutic effect of rats with HBHO-PH,in particular with moderate to severe PH.