累及主动脉弓部夹层动物模型构建方法的对比研究

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目的:对比不同方法构建累及主动脉弓部的主动脉夹层(AAD)动物模型的有效性及安全性,探索构建主动脉弓部夹层动物模型的安全有效方法。方法:24只健康杂种犬采用随机数字表法分为4组(n n=6)。A组:经静脉切开针高压水流冲击建模法;B组:经静脉切开针非高压水流冲击建模法;C组:经动脉鞘非高压水流冲击建模法;D组:双向球囊扩张联合弹性蛋白酶灌注建模法。于术后即时、术后7 d行影像学检查,术后15 d行主动脉活组织检查,并对AAD病变段进行组织病理学染色,观察AAD形成情况。收集4组实验犬的手术时间、主动脉阻断时间,计算模型构建成功率、夹层撕裂长度、术后存活率、生存时间等,比较不同方法构建AAD动物模型的有效性及安全性。n 结果:4组实验犬性别、年龄、体重差异均无统计学意义(均n P>0.05);4组实验犬的手术时间分别为(111.6±8.0)、(168.0±17.4)、(164.4±13.9)、(202.8±21.5)min,差异有统计学意义(n F=39.973,n P<0.001),其中A组手术时间低于B、C、D组(均n P<0.001)。4组实验犬的主动脉阻断时间分别为(5.2±1.8)、(19.6±3.8)、(20.6±3.9)、(18.6±3.0)min,差异有统计学意义(n F=27.598,n P<0.001),其中A组主动脉阻断时间低于B、C、D组(均n P<0.001)。4组实验犬分别有5、5、4、1只模型构建成功,差异有统计学意义(n P=0.008),其中A组模型构建成功率高于D组(n P=0.040)。4组实验犬的夹层撕裂长度分别为(14.4±3.0)、(11.3±4.2)、(7.0±2.3)、(4.7±0.6)cm,差异有统计学意义(n F=8.103,n P=0.003),其中A组夹层撕裂长度长于C、D两组(均n P<0.05)。4组实验犬的术后中位生存时间[n M(n Q1,n Q3)]分别为15.0(10.0,15.0)、5.0(3.0,10.0)、3.5(1.5,4.8)、10.0(2.8,15.0)d,差异有统计学意义(n χn 2=7.825,n P=0.036),其中A组术后平均生存时间高于B、C两组(均n P0.05). The operation time of four groups of experimental dogs were (111.6±8.0), (168.0±17.4), (164.4±13.9), (202.8±21.5)min, and the difference was statistically significant (n F=39.973, n P<0.001). The operation time of group A was significantly lower than group B, C and D (alln P<0.001). The aortic blood flow block time of four groups of experimental dogs were (5.2±1.8), (19.6±3.8), (20.6±3.9), and (18.6±3.0) min, and the difference was statistically significant (alln P<0.001). The aortic blood flow block time of group A was significantly lower than group B, C and D (n F=27.598, n P<0.001). The four groups of experimental dogs had 5, 5, 4, and 1 model were successfully constructed, respectively, and the difference was statistically significant (n P=0.008). The successful rate of model construction in group A was significantly higher than that in group D (n P=0.040). The dissection tear length of four groups were (14.4±3.0), (11.3±4.2), (7.0±2.3), (4.7±0.6) cm,and the difference was statistically significant (n F=8.103, n P=0.003). The dissection tear length of group A was significantly longer than group C, D (all n P<0.05). The postoperative survival time were 15.0(10.0, 15.0), 5.0(3.0, 10.0), 3.5(1.5, 4.8), 10.0(2.8, 15.0) days, and the difference was statistically significant (n χn 2=7.825,n P=0.036). The postoperative survival time of group A was significantly higher than group B, C (all n P<0.05). There was no significant difference in the survival rate of the four groups (n P=1.000). The pathological staining results showed that the elastic fiber at the tearing point of AAD was destroyed, and the elastic fiber on the outer wall of the false cavity was over-stretched, which was consistent with the pathological changes of aortic dissection.n Conclusion:Transvenous incision needle high-pressure water flow impact modeling method is easy to operate. The aortic blood flow block time is short, the dissection tear length is wide, and the postoperative survival time is long, can be used as the preferred method of animal AAD model construction.
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