三尖瓣关闭不全致右心重构的病理生理学改变  

The pathophysiological change of right heart remodeling model caused by tricuspid regurgitation

作　　者：廖胜杰 黄焕雷[2] 费洪文[2] 吴岳恒[2] 魏大闯[2] 肖学钧[2] 

机构地区：[1]南方医科大学,广州市510515 [2]广东省人民医院,广东省医学科学院,广州市510080

出　　处：《实用医学杂志》2014年第19期3042-3045,共4页The Journal of Practical Medicine

基　　金：广东省自然科学基金资助项目(编号:S2011010005493)

摘　　要：目的:观察三尖瓣关闭不全(TR)致右心重构比格犬模型的病理生理学变化。方法:将6只比格犬随机分为TR组和假手术组,每组3只。TR组采用心脏不停跳直视下剪除三尖瓣前、后瓣叶,造成极重度TR。运用超声心动图分别于术前和术后3、6、12个月进行检查,18个月后处死,Masson染色检查心肌纤维化程度。结果:手术成功率100%,存活率100%。TR组体重逐渐增加,超声心动图提示右房、右室增大,右心功能减退,病理检查发现TR组心肌纤维化、肝损害及大量腹水,提示发生右心重构和右心衰竭。假手术组手术前后未见差异。结论:TR组右心功能逐渐减退,并且心肌纤维化明显,是导致右心重构的病理基础之一。Objective To observe the pathophysiological change of right heart remodeling model of beagle dogs caused by tricuspid regurgitation. Methods Six beagle dogs were separated to TR group and sham operation group randomly and equally. The anterior and posterior leaflets of tricuspid valve of beagle dogs from TR group were cut off under direct vision on the beating heart. The echocardiography data were measured pre-operation and postoperation 3, 6, 12 months respectively and autopsy results were acquired after the sacrifice of two animals who had been raised for 18 months. Results The operation was successful and survival 100%. The weight of TR group increased, and the echocardiography showed right atrium and ventricle enlargement and right heart dysfunction. The autopsy of TR group found myocardial fibrosis, liver cirrhosis and ascites. All of the results indicated the occurrence of right heart remodeling and right heart failure. There is no significant difference in sham operation group before or after operation. Conclusion The myocardial fibrosis is one of the pathological basis of right heart remodeling.

关 键 词：心脏瓣膜疾病 三尖瓣关闭不全 右心重构 病理检查 动物模型 

分 类 号：R542.53[医药卫生—心血管疾病]