房间隔缺损封堵术动物模型在高+Gz歼击机飞行条件下的安全性评价  

Safety evaluation of animal model of atrial septal defect occlusion under high+Gz conditions for fighter flight

作　　者：孙津津 张海涛 王俊华 李利 黄丛春 王建昌 崔丽 徐先荣 SUN Jinjin;ZHANG Haitao;WANG Junhua;LI Li;HUANG Congchun;WANG Jianchang;CUI Li;XU Xianrong(Department of Cardiovascular Diseases,Air Force Medical Center,Beijing 100142,China;Department of Ultrasound,Air Force Medical Center,Beijing 100142,China;Department of Medical Research,Air Force Medical Center,Beijing 100142,China;Department of Sleep Medicine,Air Force Medical Center,Beijing 100142,China;Vertigo Clinical Research Center of Aerospace,Air Force Medical Center,Beijing 100142,China)

机构地区：[1]空军特色医学中心心血管内科,北京100142 [2]空军特色医学中心超声科,北京100142 [3]空军特色医学中心医研部,北京100142 [4]空军特色医学中心睡眠医学科,北京100142 [5]空军特色医学中心航空航天眩晕诊疗研究中心,北京100142

出　　处：《空军军医大学学报》2022年第5期554-558,共5页Journal of Air Force Medical University

基　　金：全军后勤科研计划重大项目(AKJ15J003)。

摘　　要：目的制作房间隔缺损(ASD)封堵术动物模型,探讨高正加速度(+Gz)作用下封堵器的稳定性,为接受ASD封堵术的歼击机飞行员的航空医学鉴定提供依据。方法选取健康西藏小型猪12头,随机分为实验组和对照组,每组各6头。实验组制作ASD模型,选用镍钛合金封堵器经股静脉行ASD封堵术。术后6个月两组通过离心机给予高+Gz暴露。暴露条件为5 Gz/60 s 1次,7 Gz/60 s 3次,9 Gz/60 s 1次,11 Gz/30 s 1次,G值增长率为1 G/s,每次加载间隔5 min。+Gz暴露前后进行心肌标志物、心电图、心脏超声检查,+Gz暴露后24 h处死动物,取房间隔封堵器复合体进行力学拉伸实验。结果①+Gz暴露后与暴露前对比、两组比较,心电图均无显著改变(P>0.05),经胸心脏超声测量左房/右室内径、左室收缩/舒张末期内径、左室收缩/舒张末期容积、射血分数等参数均值也无显著性变化(P>0.05);②+Gz暴露后4、24 h血浆肌酸激酶同工酶、肌钙蛋白I/T、C-反应蛋白、脑钠肽与暴露前对比均明显升高(P<0.05),但两组间比较无显著性差异(P>0.05);③大体解剖和光镜下观察实验组植入的封堵器完好、无移位和损伤;④房间隔封堵器复合体单向拉伸实验显示,复合体均未发生连接部位损伤、撕裂和脱位。结论ASD封堵术动物模型术后6个月,在重复高+Gz暴露下,复合体的稳固性和动物的耐受性良好,可成为ASD封堵后的歼击机飞行员特许飞行的重要依据。Objective To explore the stability of implanted occluders under high+Gz exposure by making an animal model of atrial septal defect(ASD)occlusion,so as to provide a basis for aeromedical evaluation of fighter pilots receiving ASD occlusion.Methods Twelve healthy Tibetan miniature pigs were selected and divided into experimental group and control group,with 6 pigs in each group.In the experimental group,ASD model was prepared and then closed by atrial septal occluder made by nickel-titanium alloy through femoral vein.Six months after the operation,the two groups were given high+Gz exposure in a centrifuge.The exposure conditions were 5 Gz/60 s 1 time,7 Gz/60 s 3 times,9 Gz/60 s 1 time and 11 Gz/30 s 1 time.The growth rate of G value was 1 G/s,and the loading interval was 5 min.Before and after+Gz exposure,blood samples were collected to measure the changes of myocardial markers,electrocardiogram(ECG)and cardiac ultrasound were performed,and heart samples were collected 24 h later.Mechanical tensile tests were performed on the atrial septal occluder complex,and the tensile curves were recorded and analyzed.Results①There was no significant change in ECG between the two groups after high+Gz exposure,as well as intra-group comparison before and after exposure.There was also no significant difference in the values of parameters of transthoracic echocardiography,including left atrial/right ventricular diameters,left ventricular end systolic/diastolic diameters,left ventricular end systolic/diastolic volumes and ejection fraction before and after high+Gz exposure(P>0.05).②At 4,24 h after high+Gz exposure,the levels of plasma creatine kinase isoenzyme,troponin I/T,C-reactive protein,and brain natriuretic peptide in both groups were significantly higher than those before exposure(all P<0.05),but there was no significant difference between the two groups(all P>0.05).③The ASD occluder implanted in the experimental group was intact without displacement or damage.④The uniaxial tensile test of the atrial septal occluder

关 键 词：飞行员 房间隔缺损 封堵器 高+Gz 医学鉴定 

分 类 号：R856.6[医药卫生—航空、航天与航海医学] R-332[医药卫生—临床医学]