高血流性肺动脉高压模型大鼠建立及病理生理改变

目的 建立大鼠颈总动脉与颈外静脉吻合高血流性肺动脉高压模型。方法 健康雄性SD大鼠45只分为分流组、结扎组和假手术组(n=15)。12 周后检查大鼠一般状态;超声心动图观察心脏情况、心排量及分流通畅情况;右心导管检查右心室收缩压,抽血气分析计算肺循环/体循环血流量比值(Qp/Qs); 右心室肥厚指数;肺组织HE染色及弹力纤维EVG染色。统计数据采用SPSS 16.0软件,对各组数据进行单因素方差验分析。结果 各组体重增加未见明显差异,吻合通畅率84.6%。分流组大鼠心脏明显增大,与假手术组、结扎组相比心排量明显增加(309.8±33.1)mL/min·kg比(245.6±31.9)mL/min·kg,(240.8±30.9)mL/min·kg相比,P<0.05];分流组Qp/Qs 为2.16±0.38,右心室收缩压增加至(35.8±4.9)mmHg。分流组右心室肥厚指数0.3263±0.0342,比其它两组增加明显。与假手术组相比,分流组肺动脉中膜厚度明显增加(22.3±1.7)% 比(10.6±1.7)%, P<0.05]。结论 大鼠颈总动脉与颈外静脉吻合法可以建立良好的高肺血流肺动脉高压模型。

Establishment and pathophysiology changes of pulmonary artery hypertension shunt of high blood flow by anastomosis of left common carotid artery to left external vein in rats

Objective To establish a rat model of increased blood flow-induced pulmonary arterial hypertension generated by anastomosis of the left common carotid artery to left external jugular vein. Methods 45 male SD rats were divided into three groups: the shunt group, the ligation group and the sham group. At twelve weeks after the procedure, the general status of the rats was observed. Heart conditions, cardiac output and shunt patency were measured by echocardiography. Right ventricular systolic pressure (RVSP) and Qp/Qs were checked by catheterization. Right ventricular hypertrophy index (RVHI) was calculated and lung tissues were examined by pathology using hematoxylin-eosin and elastin Van Gieson staining. All data were analyzed statistically by one-way ANOVA test using SPSS 16.0. Results There was no significant difference in body weight gains between the groups. The patency rate of shunt was 84.6%. The heart was enlarged in the group shunt. Cardiac output increased significantly in the shunt group than that in the other two groups (309.8±33.1) mL/min·kg vs. (245.6±31.9) mL/min·kg, (240.8±30.9)mL/min·kg, respectively, P<0.05]. In the shunt group Qp/Qs was 2.16±0.38 and RVSP increased to (35.8±4.9) mmHg, RVHI was 0.3263±0.0342, significantly higher than that of the other groups. The pulmonary arteriolar wall was evidently thickened in contrast to that in the sham group (22.3±1.7)% vs. (10.6±1.7)%, P<0.05). Conclusions Anastomosis of the left common carotid artery to left external jugular vein can successfully establish pulmonary arterial hypertension model induced by high blood flow in rats.