Hybrid方法建立肺血减少型先天性心脏病幼猪动物模型  

Establishment of a porcine model of congenital heart defect with decreased pulmonary blood flow

作　　者：刘学刚[1] 施超[1] 王康武[1] 刘以尧[1] 段贵新[1] 李晓红[2] 宋伟[3] 张俊祥[4] 

机构地区：[1]蚌埠医学院第一附属医院胸心外科,233004 [2]蚌埠医学院第一附属医院麻醉科,233004 [3]蚌埠医学院第一附属医院超声科,233004 [4]蚌埠医学院第一附属医院CT室,233004

出　　处：《中华心血管病杂志》2011年第1期79-83,共5页Chinese Journal of Cardiology

基　　金：安徽省高等学校省级重点自然科学研究项目（KJ2009A74）

摘　　要：目的 研究肺血减少型先天性心脏病（先心病）肺血管发育的病理生理过程及其相关调节机制,探讨肺血减少型先心病幼猪动物模型构建的可行性方法.方法 采用出生1～2个月的幼猪共20只,按照购入时的编号顺序（1～20）,随机分为3组：（1）对照组（C组,n=6）,右胸前外侧切口造成一过性肺血减少;（2）轻中度狭窄组（T1组,n=7）,右胸前外侧切口经右心房表面送入球囊扩张器行人工房间隔造口＋肺动脉Banding环缩术,术中收缩期肺动脉环缩处压差（systolic trans pulmonary artery banding pressure,Trans-PABP）20～30 mm Hg（1 mm Hg=0.133 kPa）;（3）重度狭窄组（T2组,n=7）,术中Trans-PABP≥30～50 mm Hg.术后1个月行64排CT扫描评估,2个月二次开胸手术测定动脉血气分析及血常规,测量各组血管直径及Trans-PABP,处死动物切取心肺组织测量房间隔缺损（ASD）和Banding环直径.结果 C组动物因麻醉意外,术后10 h死于呼吸衰竭1例.T1组术后21 d死于肠梗阻、肠坏死1例.T2组死亡2例,分别于术后24 b和39 d因急性和慢性右心功能衰竭死亡.T1和T2组存活动物房间隔造口＋肺动脉环缩术均获得成功.术后超声测定T1和T2组房缺大小分别为（8.0±0.5）mm、（8.9±1.4）mm（P＞0.05）,Trans-PABP术后至2个月持续显著增加,T1组由（19.1±5.6）mm Hg增加至（24.1±3.0）mm Hg（P＜0.01）,T2组由（34.2±3.9）mm Hg增加至（43.6±6.4）mm Hg（P＜0.01）.术前三组间氧分压（PaO2）和血细胞比容（Hct）差异均无统计学意义.术后2个月T1、T2组PaO2显著低于C组,且T2组低于T1,T1、T2组Hct显著高于C组,且T2组高于T1组（P＜0.05）.64排CT扫描示T1组主动脉直径（AOD）明显低于C组,T1、T2组肺动脉环缩处直径显著低于各自的AOD（P＜0.01）.结论 采用球囊扩张房间隔造口＋肺动脉环缩的方法成功的建立了理想的肺血减少型先心病模型,该模型简单可靠、经济实用,十分接�Objective To establish an animal model of congenital heart defect with decreased pulmonary blood flow for better understanding the pathophysiology of pulmonary vascular development and related regulatory mechanisms of congenital heart defect with decreased pulmonary blood flow. Method One to two months old pigs were randomly divided into three groups： control group（group C, n = 6）with right chest small incisions induced transient pulmonary blood reduction;light-moderate stenosis groups （group T1, n = 7）：artificial atrial septum defect（ASD）plus controlled pulmonary artery banding to generate a systolic pressure gradient of 20-30 mm Hg（1 mm Hg = 0. 133 kPa）;severe stenosis groups （group T2, n = 7）： similar surgical procedures as group T1, and controlled pulmonary artery banding to generate a systolic pressure gradient ≥ 30 ～50 mm Hg. 64-slice computed tomography scanning was performed at one month post operation. Arterial blood gas analysis, hemoglobin value, pulmonary vessel,ASD and banding ring diameters and trans-pulmonary artery banding pressure（Trans-PABP）were determined at two months post operation. Results One pig died due to tracheal intubation accident in the C group, one pig died due to bowel obstruction in the T, group and two pigs died due to acute right heart failure and chronic heart failure respectively in T2 group. 64-slice CT angiography results showed that aortic diameter of T1 group was significantly lower than that of C group and banding diameter was significantly lower than aortic diameter in the T1 and T2 groups at one month post operation. Two months after operation, the size of ASD were（8.0 ± 0. 5）mm and（8.9 ± 1.4）mm（P 〉 0. 05）respectively in the T1 and T2 groups after operation. The Trans-PABP was significantly higher in the T1 and T2 groups than in C group（P 〈0. 01）, and the Trans-PABP was significantly higher in the T2 group than in T1 group（P 〈0. 01）. PaO2 and SaO2 in the T1 and T2 groups were significantly lower than those in

关 键 词：心脏缺损 先天性 模型 动物 

分 类 号：R-332[医药卫生]