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目的探讨在非人工通气的条件下通过升主动脉缩窄的方法建立主动脉瓣上狭窄模型的可行性并进行评价。方法将20只新西兰大白兔完全随机分为升主动脉缩窄组(n=12)和假手术组(n=8)。在非人工通气的条件下,在主动脉近端根部结扎升主动脉,使其缩窄。假手术组只行开胸手术,不行升主动脉结扎。术后2、4、8、12、16、20、24周行超声心动图检查,测量心室内径及心功能。术后8、24周行光学显微镜及透射电子显微镜检查,观察心肌组织形态学改变。结果超声心动图检查示:升主动脉缩窄组术后8周时左室质量指数(left ventricular mass index,LVMI)明显增大[(2.30±0.11)mg/g],较术前[(1.02±0.05)mg/g]及假手术组[(0.98±0.01)mg/g]均有显著差异(P<0.01),左室短轴缩短率(fractional shortening,FS%)自术后4周始逐渐下降,术后24周时较术前降低了9.3%,有显著差异(P<0.01)。组织学检查示:心肌纤维排列紊乱,心肌细胞肥大,间质胶原纤维显著增生。结论通过非人工通气升主动脉缩窄的方法成功建立了兔主动脉瓣上狭窄的模型,该方法简单、有效、重复性好。
Objective To investigate the feasibility of establishing aortic stenosis model by ascending aorta stenosis under non-artificial ventilation. Methods Twenty New Zealand white rabbits were randomly divided into ascending aortic constriction group (n = 12) and sham operation group (n = 8). In the non-artificial ventilation conditions, the proximal aortic ligation of the ascending aorta, to narrow. Sham-operated group only underwent thoracotomy, not ascending aortic ligation. Echocardiography was performed at 2, 4, 8, 12, 16, 20, 24 weeks after operation to measure the ventricular diameter and cardiac function. At 8 and 24 weeks after surgery, optical microscopy and transmission electron microscopy were performed to observe the morphological changes of myocardial tissue. Results Echocardiography showed that left ventricular mass index (LVMI) increased significantly (2.30 ± 0.11 mg / g) at 8 weeks after ascending aorta stenosis compared with preoperative [(1.02 ± 0.05) mg / g] and sham operation group [(0.98 ± 0.01) mg / g], respectively. The fractional shortening (FS% (P <0.01). The difference was statistically significant (P <0.01). Histological examination showed: myocardial fiber disorder, myocardial cell hypertrophy, interstitial collagen fibers significantly proliferated. Conclusion The model of aortic stenosis in rabbits was successfully established by non-artificial ventilation and aortic constriction. The method is simple, effective and reproducible.