一种慢性主动脉瓣关闭不全动物模型建立的实验研究  

Experimental study on establishment of an animal model of chronic aortic insufficiency

作　　者：宗刚军[1] 吴刚勇[1] 夏阳[1] 陈景开[1] 陈满清[1] 王璐璐[1] 石屹城[1] 

机构地区：[1]解放军第101医院心血管内科,江苏无锡214044

出　　处：《心脏杂志》2011年第6期723-726,共4页Chinese Heart Journal

摘　　要：目的:探讨通过介入方法破坏主动脉瓣膜,建立一种慢性主动脉瓣膜关闭不全犬模型的可行性。方法:选择体质量为(18.3±4.6)kg的健康犬10只。经皮送入加硬导丝,在超声引导下穿破主动脉瓣叶,同时进行球囊扩张瓣叶穿孔处。主动脉瓣上造影检查瓣膜破裂口有无明显的反流,心脏超声检查评估主动脉瓣膜的反流量以及左室射血分数。术后将实验犬饲养两个月,再次复查心脏超声评估主动脉瓣膜的反流量及左心室的功能。结果:10只实验犬中,除两只在建立急性主动脉瓣膜破裂伤时,导丝穿入心肌导致心包填塞,而放弃继续操作外,其余8只犬手术成功,主动脉瓣膜的瞬时反流量达到(5.2±0.8)ml/s。术后第20天、35天,各有1只实验犬死于心力衰竭,其余6只犬存活到两个月。所有存活实验犬均出现活动耐量的减退。复查心脏超声提示,主动脉瓣瞬时反流量为(8.4±1.2)ml/s,比术后即刻有明显增加;左室射血分数为(42.5±1.1)%,比术后即刻明显降低;左心室容积为(69.5±6.8)ml,左心室壁厚度为(8.6±1.7)mm,比术后即刻有明显的增加,以上各项指标差异均有统计学意义(P<0.05)。结论:通过经皮穿刺主动脉瓣叶加球囊扩张的方法,建立慢性主动脉瓣关闭不全的犬模型可行,效果理想。AIM： To explore the feasibility of establishing a chronic aortic valve regurgitation animal model by interventional destruction of the aortic valve.METHODS： Ten healthy dogs weighing an average of（18.3±4.6） kg were used.The hard wire was advanced to pierce the aortic valve leaflets under ultrasound guidance.At the same time,a balloon was inflated in the valve leaflet perforation.Angiography revealed obvious reflux through the valve leaflet perforation.Color Doppler echocardiogram was immediately used to evaluate aortic valve regurgitation and left ventricular ejection fraction.After 2 months,all surviving dogs were examined to evaluate aortic valve regurgitation and left ventricular ejection fraction with color Doppler echocardiography.RESULTS： Acute aortic valve rupture was not established in two dogs because the guide wire perforated the myocardium and led to cardiac tamponade.The operation on the other eight dogs was successful and instant aortic valve regurgitation by intraoperative echocardiography was（5.2±0.8） ml/sec.Two of the 8 dogs died of heart failure,respectively,on day 20 and day 35 and the other six dogs survived up to 2 months.Decrease of exercise tolerance was found in all surviving dogs.Compared with those immediately postoperative,the instant aortic valve regurgitation was（8.4±1.2） ml/sec,left ventricular volume was（69.5±6.8） ml and the left ventricular wall thickness（8.6±1.7） mm was significantly increased.Left ventricular ejection fraction was significantly decreased（42.5±1.1）%.Differences were all statistically significant（P0.05）.CONCLUSION： It is feasible to establish a chronic aortic insufficiency animal model by percutaneous aortic valve puncture plus balloon dilation with satisfactory results.

关 键 词：介入方法 主动脉瓣关闭不全 动物模型 犬 

分 类 号：R542.52[医药卫生—心血管疾病]