光学相干断层成像检测家兔腹主动脉易损斑块的实验研究

目的评价光学相干断层成像(optical coherence tomography,OCT)在检测易损斑块中的应用价值。方法选取30只雄性纯种的新西兰大白兔,随机分为球囊损伤组(建立家兔腹主动脉易损斑块模型),高脂对照组及正常对照组,每组10只。前2组高脂喂养,喂养12周后,分别给予中国斑点蝰蛇毒和组胺药物触发,诱发斑块破裂及血栓形成后进行OCT,并与病理结果对照检测OCT效果。结果球囊损伤组存活的8只白兔中有10处病变狭窄程度>50%,脂质核心较大、纤维帽厚度>65μm,判定以上10处病变为易损斑块;高脂对照组存活的9只白兔仅3处可判定为易损斑块;正常对照组中未见易损斑块。3组102个OCT图像与病理检测动脉内膜厚度[(20.2±7.6)μmvs(15.2±0.9)μm]、中膜厚度[(453.81±87.2)μmvs(434.2±86.5)μm]、斑块厚度[(392.2±34.5)μmvs(380.2±57.1)μm]比较,差异无统计学意义(P>0.05)。OCT测量球囊损伤组易损斑块和稳定斑块血管外弹力膜面积[(16.01±4.44)μmvs(10.32±2.44)μm]和斑块面积[(8.08±2.37)μmvs(6.80±2.17)μm]比较,差异有统计学意义(P<0.01)。结论 OCT是一种判定易损斑块病变特征的有效手段,可以诊断易损斑块、指导临床制定治疗策略。

Application of optical coherence tomography in detecting rabbit vulnerable abdominal artery plaques

Objective To assess the value of optical coherence tomography(OCT)in detecting rabbit vulnerable abdominal artery plaques.Methods Thirty New Zealand white rabbits were randomly divided into balloon injury group,high fat diet group and control group(10in each group).A rabbit model of vulnerable abdominal artery plaques was established.The animals in balloon injury group and high fat diet group were fed with high fat diet for 12 weeks followed by Chinese Russell's viper venom and histamine to induce plaques and thrombosis.The animals then underwent OCT.The OCT findings were compared with the pathological findings.Results The stenosis was>50%in 8suvived rabbits of balloon injury group with a larger lipid core and a fibrous cap thichness<65μm,indicating that the lesions can be defined as vulnerable plaques.Vulnerable plaques were detected in 9rabbits of high fat diet group and no vulnerable plaque was observed in control group.No significant difference was found in endaterium thickness and intima-media thickness(20.2±7.6μmvs 15.2±0.9μm,453.81±87.2μmvs 434.2±86.5μm,P>0.05).The plaque thickness was 392.2±34.5μmvs 380.2±57.1μm.The external elastic membrane area of the vulnerable plaque and stable plaque measured by the OCT were 16.01±4.44μmvs 10.32±2.44μm,and the plaque area was(8.08±2.37μmvs 6.80±2.17μm,P<0.01).Conclusion OCT can effectively show the features of vulnerable plaques,thus playing an important role in diagnosis of vulnerable plaques and in working out of treatment strategies for coronary artery disease.