介入和外科技术相结合建立紫绀型肺血减少型先天性心脏病幼猪动物模型  

A Novel Hybrid Method Creating the Porcine Model of Cyanotic Congenital Heart Defect with Decreased Pulmonary Blood Flow

作　　者：许耀强[1] 刘迎龙[1] 吕小东[1] 于存涛[1] 李晓锋[1] 

机构地区：[1]北京协和医学院中国医学科学院阜外心血管病医院小儿心脏中心,北京100037

出　　处：《解剖与临床》2009年第3期147-150,共4页Anatomy and Clinics

基　　金：北京自然科学基金课题（7072049）

摘　　要：目的：采用一种新颖的介入和外科相结合的Hybrid方法建立紫绀型肺血减少型先天性心脏病动物模型。方法：采用生后1～2月的幼猪，分为两组，每组8只。正常对照组（C组）单纯开胸。肺血减少组（D组）经右前外侧第3肋间开胸，经右心房表面送入扩张器行人工房间隔造口术，再经左前外侧第3肋间开胸，将主肺动脉套环缩带。术后常规喂养8周，二次开胸，测量跨肺动脉环缩处的压差。分别抽外周动脉、右心房、肺静脉、肺动脉血行血气分析，计算Qp／Qs；同时抽外周静脉血测量血球压积（HCT）和血红蛋白浓度（HB）。结果：C组8只均存活，体重增加到23．0kg。D组存活6只，体重增加到20．6kg。D组的动脉血氧分压（PaO2）、动脉血氧饱和度（SaO2）、HCT和HB分别为52．9mmHg、85．6％、49．8％和16．6g／dl，C组的分别为118．0mmHg、98．0％、37．9％和12．2g／dl。两组间对应指标相比差异有统计学意义（P〈0．001）。利用四点血气值和公式计算得出D组Qp/Qs为0．54：1。结论：应用介入和外科相结合的Hybrid方法，通过人工房间隔造口和肺动脉环缩，成功建立了一种新颖的紫绀型肺血少先天性心脏病动物模型；利用该模型可对紫绀型肺血减少型先心病的病理生理进行深入的研究。Objective：To create an experimental model of cyanotic congenital heart defect with decreased pulmonary blood flow by a novel hybrid method. Methods ： An chronic model of congenital heart defect with decreased pulmonary blood flow and chronically developed cyanosis was surgically produced in 8 piglets （ 1 -2 months old） by creating an artificial atrial septal defect through a incision of the right, third intercostal space and banding pulmonary artery through a incision of the left, third intercostal space （ cyanosis group）. Another 8 piglets underwent a sham operation that did not include atrioseptestomy and pulmonary artery banding but did include 30 minutes of side clamp of the main pulmonary artery （PA） through a left anterolateral thoracotomy （control group）. At a mean duration of 2 months after a hybrid procedure, the chest of these piglets was then reopened via a median sternotomy, Right ventricular and pulmonary artery pressures were recorded by direct puncture of a pressure-monitoring catheter. Blood samples were drawn for hematocrit, PaO2 and SaO2 determination preoperatively and 2 months postoperatively. The blood gas samples were drawn from four positions including the aortic, right atrium, pulmonary vein and pulmonary artery for calculating the Qp / Qs. Results： At a mean duration of 2 months postoperatively, there were 6 long-term survivors in cyanosis group whose body weight increased to 20.6 kg. The resting gradient across the pulmonary artery band was 53.7mmHg. Qp/Qs reached 0.54 ： 1. The arterial oxygen tension （ PO2 ）, arterial oxygen saturation （ SaO2 ）, hematocrit value （HCT） and hemoglobin concentration （HB） were 52.9 mmHg, 85.6%, 49.8% and 16.6g/dl in cyanosisgroup versus 118.0 mmHg, 98.0% , 37.9% and 12.2 g/dl in control group respectively （all P 〈0. 001 ）. Conclusions：A porcine model of cyanotic congenital heart defect with decreased pulmonary blood flow could be successfully established by a hybrid method. Application of this experimental de

关 键 词：先天性心脏病 紫绀 动物模型 幼猪 

分 类 号：R541.1[医药卫生—心血管疾病]