一种新的三尖瓣关闭不全致右心重构动物模型的建立  

A new animal model of right heart remodeling caused by tricuspid regurgitation

作　　者：廖胜杰 黄焕雷[1] 肖学钧[1] 费洪文[2] 吴岳恒[3] 魏大闯[1] 

机构地区：[1]广东省人民医院心外科广东省心血管病研究所,广州510080 [2]广东省人民医院超声心动图室,广州510080 [3]广东省人民医院中心实验室,广州510080

出　　处：《中华实验外科杂志》2015年第1期187-189,共3页Chinese Journal of Experimental Surgery

基　　金：广东省自然科学基金资助项目（S2011010005493）

摘　　要：目的 建立一种新的三尖瓣关闭不全（TR）致右心重构的动物模型.方法 以比格犬为实验对象,采用右侧开胸短时阻断上、下腔静脉,切开右心房,心脏不停跳直视下剪除三尖瓣叶,根据术中心脏超声TR与右心房面积比（TR/RA）分为重度TR组（n=8,40％≤TR/RA＜ 70％）、极重度TR组（n=3,TR/RA≥70％）,假手术组为对照组（n=3,无TR）.超声心动图定期追踪检查,对饲养满18个月的2条犬处死,取器官组织标本.结果 手术成功率为100％,最长饲养超过540 d,存活率为100％.手术组犬体质量逐渐增加,部分犬出现腹水.超声心动图提示右心房、右心室增大,右心功能减退,处死的手术组比格犬解剖发现肝硬化及大量腹水,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 直视下剪除三尖瓣叶可成功建立TR致右心重构的动物模型,具有操作简单、可控性强、存活率高等特点,是研究右心重构的理想动物模型.Objective To establish a new animal model of right heart remodeling caused by tricuspid regurgitation.Methods The beagle dogs were taken as experimental objects （n =14）.Firstly,the superior and inferior vena cava were blocked briefly,secondly the right atrium was open,at last the tricuspid valves of beagle dogs were cut off under direct vision on the beating heart.The dogs were divided into operation group and sham operation group at random.Through the echocardiography data of pre-operation,post-operation 3,6,12 months respectively and autopsy results after sacrifice of two animals whom had been raised for 18 months to estimate right ventricular remodeling happens or not.Results 8 beagle dogs were cut off the anterior tricuspid valve,and 3 dogs were cut off the anterior and posterior tricuspid valves with 100% successful rate and 100% survival rate.According to the ratio of TR area and right atrial area （TR/RA）,the beagle dogs were divided into severe TR group （40% ≤TR/RA 〈70%） with 8 dogs and very severe TR group （TR/RA ≥70%） with 3 dogs and sham operation group with 3 dogs.The longest one has raised above 540 days,and no natural death occurred so far.The weight of operation group increased,and the echocardiography showed right atrium and ventricle enlargement and right heart dysfunction.The autopsy of one of operation group dogs found 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 By cutting off the tricuspid valves through lateral thoracotomy can established a new animal model of right heart remodeling caused by tricuspid regurgitation successfully,which is controllable,repeatable and high successful and survival rate.It is an ideal animal model for the study of right heart remodeling.

关 键 词：三尖瓣关闭不全 右心室重构 模型 动物 

分 类 号：R654.2[医药卫生—外科学]