急性脑卒中血栓模型的制备及评价  

The preparation and evaluation of thrombus model used for acute ischemic stroke

作　　者：邵秋季[1] 朱良付[1] 李天晓[1] 李杜娟[2] 赵文丽[3] 任伟[3] 贺迎坤[1] 蔡栋阳 梁晓东[1] 杨博文[1] 

机构地区：[1]郑州大学附属河南省人民医院介入治疗中心,450003 [2]郑州大学附属河南省人民医院病理科,450003 [3]郑州大学附属河南省人民医院导管室,450003

出　　处：《中华放射学杂志》2014年第6期496-500,共5页Chinese Journal of Radiology

摘　　要：目的：应用流体模型法制备一种适用于评价急性缺血性脑卒中机械取栓装置的新血栓模型，并评价其特性。方法采用动态血栓形成系统制备流体模型血栓，同时采用传统静止法制备血栓。通过手动拉伸试验（各15个血栓样本）和导管注射试验（各15个血栓样本）来进行血栓机械性能的检测。将上述2种模型血栓（各5个）及5例卒中患者的血栓标本进行HE染色，并对3种血栓的病理结果进行比较。选取2只猪，以流体模型血栓建立急性猪血管栓塞模型，评估其显影性。2种血栓最大拉伸长度的比较采用独立样本t检验，导管注射实验后血栓断裂率通过Fisher精确检验进行比较。结果2种模型血栓的最大拉伸长度分别为（4.28±0.23）和（3.16±0.13） cm，差异有统计学意义（t＝16.38，P＜0.01）；经导管注射实验后的断裂率分别为13％（2/15）和60％（9/15），静止法制备的血栓的断裂率高于流体模型制备的血栓，差异同样具有统计学意义（ P＜0.05）。流体模型制备的血栓显示出同卒中患者的血栓标本类似的混合性血栓结构，而静止模型血栓镜下仅见大量红细胞分布；2只猪的舌动脉、颈浅动脉共8根血管均成功实现栓塞，且显影良好。结论流体模型制备的血栓机械性能稳定、显影性好，且同卒中患者的在体血栓具有类似的组织学结构。Objective To prepare a new thrombus model by fluid model method , which is suitable for evaluation of mechanical thrombectomy devices for acute stroke.Methods The fluid model adopted the Chandler loop theory , while the static model adopted conventional method.Mechanical properties of thrombi prepared by fluid model and static model were measured by manual elongation test （ 15 samples in each group） and catheter injection test （15 samples in each group ）.Histological structure was compared among the above thrombus models （ 5 samples in each group ） and specimens of five patients with stroke by hematoxylin-eosin staining method.Then, thrombi in fluid model were utilized to establish embolization of vessels in swine model （ two pigs ） for evaluation of radiopacity.Independent-Sample test was performed to compare the maximum tensile length of two methods , and Fisher′s exact test was used to compare the rate of thrombus fragmentation after catheter injection test.Results The maximum tensile length of two models were （4.28 ±0.23） and （3.16 ±0.13） cm, respectively, and the difference was statistically significant （t=16.38, P〈0.01）;After catheter injection, the fracture rates of thrombus were 13% （2/15） and 60%（9/15）, which were also statistically significant （P〈0.05）.As to histological structure, thrombi prepared by fluid model showed mixed thrombus structure , which similar to thrombi of stroke patients , But thrombi prepared by static model were replete with erythrocytes under the microscope .A total of eight vessels （ lingual arteries and superficial cervical arteries ） in two swines were successfully occlusive （ TIMI 0 or 1 ） , and sufficient radiopacity of each injected thrombus was observed.Conclusions The thrombi prepared by fluid model not only have good mechanical stability and sufficient radiopacity , but their histological structure is similar to thromboemboli retrieved from cerebral arteries of patients with acute stroke.

关 键 词：卒中 血栓形成 模型 动物 

分 类 号：R743.3[医药卫生—神经病学与精神病学]