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目的:应用野百合碱(MCT)诱导建立大鼠肺动脉高压(PAH)模型,运用微型CT和磁共振心功能成像方法,研究肺动脉压力演变和右心室结构、功能演变之间的关系。材料与方法:将MCT诱导的PAH模型组(1 wk-PAH组、2 wk-PAH组、3 wk-PAH组、4 wk-PAH组)和每一个模型组的对照组大鼠分别随机分组(每小组12只),分别在第1、2、3和4周右心导管测量肺动脉压力,微型CT测量主肺动脉直径及右心室与左心室最大径比值,MRI右心功能动态检测,观察肺动脉压力和MRI参数演变关系。比较对照组、PAH模型组各组间的相关各参数差异。采用SPSS 17.0统计软件,应用Pearson相关性分析,评价右心室射血分数,右室舒张末期容积,右室收缩末期容积,右心室与左心室最大径比值和主肺动脉直径分别与平均肺动脉压的相关性,组间比较采用完全随机分组的t检验,P<0.05为差异具有统计学意义。结果:注射野百合碱后1至4周,48只模型组大鼠的右心室射血分数、右心室舒张及收缩末期容积与平均肺动脉压有很好的相关性(分别为rRVEF=-0.823,rRVEDV=0.732,rRVESV=0.803)。右心室与左心室最大径比值与平均肺动脉压有轻度相关(r=0.694),主肺动脉直径与平均肺动脉压无相关性,r=0.438。注射野百合碱前两周,野百合碱组大鼠的平均肺动脉压、射血分数、右室舒张末期和收缩末期容积、右心室与左心室最大径比值与对照组比较未见显著差异(P>0.05)。3周到4周后,以上各参数与对照组比较有显著性差异(P<0.05)。结论:随着大鼠的肺动脉压增高,右心室与左心室最大径比值增加,右心室射血分数逐渐降低,右心室舒张末期及收缩末期容积逐渐增加。对于大鼠慢性肺动脉高压模型的监测,CT和MRI可以准确快速测量各项参数变化,简单易行。右心室舒张末及收缩末期容积、射血分数等参数是提示肺动脉高压的敏感参数。
OBJECTIVE: To establish a model of pulmonary hypertension (PAH) induced by monocrotaline (MCT) in rats and study the relationship between pulmonary arterial pressure changes and right ventricular structure and function evolution by using mini-CT and magnetic resonance imaging. Materials and Methods: MCT-induced PAH model group (1 wk-PAH group, 2 wk-PAH group, 3 wk-PAH group, 4 wk-PAH group) and control group rats of each model group were randomly divided into (N = 12 in each group). The right pulmonary artery pressure was measured at the 1st, 2nd, 3rd and 4th weeks respectively. The diameter of the main pulmonary artery and the ratio of the right ventricle to the left ventricle were measured by mini-CT. The right ventricular function was detected dynamically by MRI. The evolution of the parameters. Comparing the control group, PAH model group differences between the various parameters. Pearson correlation analysis was used to evaluate the correlation between right ventricular ejection fraction, right ventricular end-diastolic volume, right ventricular end-systolic volume, right ventricular and left ventricular maximum diameter ratio, and main pulmonary artery diameter and mean pulmonary artery pressure using SPSS 17.0 statistical software Sex, between groups were compared using a completely randomized t test, P <0.05 for the difference was statistically significant. RESULTS: Right ventricular ejection fraction, right ventricular diastolic and end-systolic volumes of 48 rats in model group had good correlation with mean pulmonary arterial pressure (rRVEF = -0.823, rRVEDV = 0.732, rRVESV = 0.803). The ratio of the maximum diameter of the right ventricle to the left ventricle was mildly correlated with mean pulmonary arterial pressure (r = 0.694). There was no correlation between the diameter of the main pulmonary artery and the mean pulmonary arterial pressure, r = 0.438. The mean pulmonary artery pressure, ejection fraction, right ventricular end-diastolic and end-systolic volume and the ratio of the maximum diameter of right ventricle and left ventricle in the monocrotaline group were not significantly different from those in the control group (P > 0.05). After 3 weeks to 4 weeks, the above parameters were significantly different from the control group (P <0.05). CONCLUSION: With the increase of pulmonary arterial pressure in rats, the ratio of the maximum diameter of right ventricle to left ventricle increases, the right ventricular ejection fraction decreases gradually, and the volume of right ventricular end-diastolic and end-systolic increases gradually. For the monitoring of chronic pulmonary hypertension model in rats, CT and MRI can accurately and quickly measure changes in various parameters, simple and easy. Right ventricular end-diastolic volume and end-systolic volume, ejection fraction and other parameters are sensitive parameters of pulmonary hypertension.