【摘要】：第一部分 小鼠心肌補(bǔ)片模型的建立 目的建立一種用于進(jìn)行心肌修復(fù)研究的小鼠心肌補(bǔ)片模型。 方法C57BL小鼠共60只,麻醉后行氣管插管,經(jīng)左側(cè)第4肋間開胸,于左心室前側(cè)壁行部分心肌剪除,膠原心肌補(bǔ)片修補(bǔ),止血后逐層關(guān)胸,觀察小鼠術(shù)后存活情況、術(shù)后4周心功能變化和術(shù)后1周心肌組織學(xué)檢查。 結(jié)果術(shù)后4周存活41只,心肌石蠟切片可見膠原補(bǔ)片在位,部分左心室外壁缺損,6只小鼠心功能有下降明顯(EF%60%),其中5只小鼠存在心肌梗死。 結(jié)論通過圍手術(shù)期的操作技術(shù)和方法的改進(jìn),可以提高小鼠心肌補(bǔ)片模型的成功率,為心肌損傷修復(fù)研究提供了一種可供選擇的模型。 第二部分 波生坦治療肺動脈高壓療效和安全性的Meta分析 目的評價波生坦治療肺動脈高壓的有效性與安全性。 方法電子檢索Cochrane對照試驗注冊數(shù)據(jù)庫(2010年第3期)、PubMed、EMbase、CBM、CNKI(從建庫至2010年9月)。評價納入研究的方法學(xué)質(zhì)量,采用RevMan 5.0軟件進(jìn)行Meta分析。 結(jié)果共納入7個RCT,包括714例病人。Meta分析結(jié)果顯示：波生坦能夠改善部分肺動脈高壓患者的活動能力,降低平均肺動脈壓；能夠使肝功能損害發(fā)生率增高,[OR=2.35,95%CI (1.06,5.18), p=0.03],病情原因所致退出無統(tǒng)計學(xué)差異,[OR=0.77,95%CI (0.43,1.40), p=0.40]. 結(jié)論現(xiàn)有證據(jù)表明,波生坦治療肺動脈高壓有效,不增加病情原因所致退出；增加肝功能損害發(fā)生率,但停藥后可改善。限于對各指標(biāo)可合并的研究有限,還需要大樣本、高質(zhì)量的隨機(jī)對照試驗來進(jìn)一步評價。
[Abstract]:Part one the establishment of mouse myocardial patch model objective to establish a mouse myocardial patch model for myocardial repair. Methods 60 C57BL mice were anesthetized, tracheal intubation was performed, left fourth intercostal thoracotomy was performed, partial myocardial clipping was performed on the left ventricular anterior wall, collagen myocardial patch was repaired, chest was closed layer by layer after hemostasis, the survival of the mice was observed after operation. Cardiac function was changed 4 weeks after operation and myocardial histological examination was performed 1 week after operation. Results 41 rats survived 4 weeks after operation. Collagen patch was found in paraffin section of myocardium, partial left ventricular external wall defect was found, cardiac function decreased significantly (EF'%) in 6 mice, and myocardial infarction was found in 5 mice. Conclusion the improvement of operation technique and method in perioperative period can improve the success rate of myocardial patch model in mice and provide an alternative model for the study of myocardial injury repair. Part II: Meta analysis of the efficacy and safety of Bosentan in the treatment of pulmonary hypertension objective to evaluate the efficacy and safety of Bosentan in the treatment of pulmonary hypertension. Methods Cochrane controlled trial registration database (issue 3, 2010) and PubMed,EMbase,CBM,CNKI (from construction to September 2010) were searched electronically. To evaluate the quality of methodology included in the study, Meta analysis was carried out with RevMan 5.0 software. Results there were 714 patients with 7 RCT, included. The results of Meta analysis showed that Boshentan could improve the activity and decrease the mean pulmonary artery pressure in some patients with pulmonary hypertension. The incidence of liver function damage was increased [OR=2.35,95%CI (1.06 鹵5.18), p0.03]. There was no significant difference in the cause of the disease. [OR=0.77,95%CI (0.43 鹵1.40), p < 0.40]. Conclusion the available evidence shows that Boshentan is effective in the treatment of pulmonary hypertension without increasing the incidence of liver function damage, but it can be improved after withdrawal. Limited research on indicators can be combined, and large sample, high-quality randomized controlled trials are needed for further evaluation.
【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R-332;R543.2

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