不同急性肺動(dòng)脈高壓模型的建立及其血流動(dòng)力學(xué)轉(zhuǎn)歸的實(shí)驗(yàn)研究
發(fā)布時(shí)間：2018-12-19 07:26
【摘要】：目的：1.建立葡聚糖法、縫線線段法和自體血栓法急性肺動(dòng)脈高壓動(dòng)物模型2.探討上述3種實(shí)驗(yàn)方法建立急性肺動(dòng)脈高壓模型的優(yōu)劣(有效性、實(shí)用性、可重復(fù)性和穩(wěn)定性)3.探討縫線線段法建立急性肺動(dòng)脈高壓后血流動(dòng)力學(xué)的變化 方法：實(shí)驗(yàn)犬15只,隨機(jī)分成葡聚糖法組、縫線線段法組和自體血栓法組,每組5只。通過(guò)心導(dǎo)管經(jīng)肺動(dòng)脈內(nèi)注射葡聚糖、縫線線段、自體血栓建立相應(yīng)急性肺動(dòng)脈高壓動(dòng)物模型。心導(dǎo)管測(cè)量右心室收縮壓評(píng)估各實(shí)驗(yàn)方法優(yōu)劣,在縫線線段法組中通過(guò)測(cè)定心導(dǎo)管各壓力指標(biāo)如右室收縮壓RVSP、肺動(dòng)脈收縮壓PASP、左室收縮壓LVSP、收縮期左室壓力最大上升速率dp/dtmax-LV、主動(dòng)脈收縮壓AOSP;使用超聲心動(dòng)圖測(cè)量容量指標(biāo)如心輸出量CO、左室內(nèi)徑LV、右室內(nèi)徑RV、肺動(dòng)脈內(nèi)徑PA、主動(dòng)脈內(nèi)經(jīng)AO、左室舒張末容積EDV-LV、左室射血分?jǐn)?shù)EF-LV、右室舒張末容積EDV-RV、右室射血分?jǐn)?shù)EF-RV研究血流動(dòng)力學(xué)變化。 結(jié)果：葡聚糖法肺動(dòng)脈收縮壓(PASP)于120min達(dá)到峰值,在180min時(shí)有明顯下降(P0.05,差別有統(tǒng)計(jì)學(xué)意義),標(biāo)準(zhǔn)差的均值為4.98mmHg；縫線線段法PASP于120min達(dá)到峰值,在180min有下降但不明顯,標(biāo)準(zhǔn)差的均值為4.83mmHg；自體血栓法PASP于90mmin達(dá)到峰值,在180mmin有明顯降低(P0.05,差別有統(tǒng)計(jì)學(xué)意義),標(biāo)準(zhǔn)差的均值為12.12mmHg,較上述兩種方法有顯著差異。葡聚糖法、縫線線段法在可重復(fù)性(穩(wěn)定性)上優(yōu)于自體血栓法(P0.05),縫線線段法與葡聚糖法比較該測(cè)值差異無(wú)統(tǒng)計(jì)學(xué)意義((P0.05)。急性肺動(dòng)脈高壓模型建立后,在肺動(dòng)脈壓中度增高,右室壓力負(fù)荷中度增重時(shí),右室和肺動(dòng)脈擴(kuò)張,主動(dòng)脈收縮壓略減低,心輸出量輕度下降((P0.05)；重度肺動(dòng)脈高壓時(shí),右室壓力負(fù)荷重度增重,右室進(jìn)一步擴(kuò)張,左室內(nèi)徑及容量減少,心輸出量嚴(yán)重降低(P0.05)。 結(jié)論：1.葡聚糖法、縫線線段法和自體血栓法均可成功有效的建立急性肺動(dòng)脈高壓動(dòng)物模型。2.葡聚糖法、縫線線段法在可重復(fù)性(穩(wěn)定性)上優(yōu)于自體血栓法,縫線線段法與葡聚糖法比較具有更好的持久性,但其差異無(wú)統(tǒng)計(jì)學(xué)意義。3.縫線線段法是建立急性肺動(dòng)脈高壓動(dòng)物模型及研究其血流動(dòng)力學(xué)變化簡(jiǎn)便有效的方法。急性肺動(dòng)脈高壓時(shí)左右心室均有明顯的血流動(dòng)力學(xué)變化,可為急性肺栓塞的臨床評(píng)估和治療決策提供幫助。
[Abstract]:Objective: 1. The animal models of acute pulmonary hypertension with dextran method, suture line segment method and autologous thrombus method were established. To investigate the advantages and disadvantages (effectiveness, practicability, repeatability and stability) of the above three experimental methods in the establishment of acute pulmonary hypertension (APH) model. To investigate the changes of hemodynamics after acute pulmonary hypertension established by suture line segment method, 15 dogs were randomly divided into dextran group, suture line segment group and autologous thrombus group, with 5 dogs in each group. The animal model of acute pulmonary hypertension was established by injecting dextran into pulmonary artery through cardiac catheterization suture line and autologous thrombus. Right ventricular systolic blood pressure (RVSBP) was measured by cardiac catheterization. In suture line segment group, the right ventricular systolic pressure (RVSP,), pulmonary systolic pressure (PASP,), left ventricular systolic pressure (LVSP,) were measured by measuring the cardiac catheterization parameters, such as right ventricular systolic pressure (RVSP,), left ventricular systolic pressure (LVSP,). Systolic left Ventricular pressure maximum rising rate dp/dtmax-LV, Aortic systolic pressure AOSP; Use echocardiography to measure volume such as cardiac output CO, left ventricular diameter LV, right ventricular diameter RV, pulmonary artery diameter PA, aorta transAO, left ventricular end-diastolic volume EDV-LV, left ventricular ejection fraction EF-LV, Right ventricular end diastolic volume (EDV-RV,) right ventricular ejection fraction (EF-RV) was used to study hemodynamic changes. Results: the pulmonary arterial systolic pressure (PASP) of dextran method reached the peak value in 120min and decreased significantly at 180min (P0.05, the difference was statistically significant), and the mean value of standard deviation was 4.98mmHg. The suture line segment PASP reached its peak value in 120min, but decreased but not obvious in 180min, and the average standard deviation was 4.83 mm Hg. The PASP of autologous thrombus method reached the peak value in 90mmin and decreased significantly in 180mmin (P0.05, the difference was statistically significant), and the mean standard deviation was 12.12mmHg, which was significantly different from that of the two methods mentioned above. Dextran method, suture line segment method in repeatability (stability) is better than autologous thrombus method (P0.05), suture line segment method and dextran method compared with the value of the measurement no significant difference (P0.05). After the establishment of acute pulmonary hypertension model, the right ventricle and pulmonary artery dilated, aortic systolic pressure decreased slightly and cardiac output decreased slightly when pulmonary artery pressure increased moderately and right ventricular pressure load moderately increased (P0.05). In severe pulmonary hypertension, the right ventricular pressure load increased significantly, the right ventricle further dilated, the left ventricular diameter and volume decreased, and the cardiac output decreased significantly (P0.05). Conclusion: 1. Dextran method, suture line segment method and autologous thrombus method can be successfully and effectively established acute pulmonary hypertension animal model. 2. Compared with dextran method, suture line segment method is more persistent than autologous thrombus method in repeatability (stability), but the difference is not statistically significant. Suture line segment method is a simple and effective method to establish animal model of acute pulmonary hypertension and to study its hemodynamic changes. The left and right ventricle have obvious hemodynamic changes during acute pulmonary hypertension, which can be helpful for clinical evaluation and treatment decision of acute pulmonary embolism.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R543.2;R-332
本文編號(hào)：2386601
[Abstract]:Objective: 1. The animal models of acute pulmonary hypertension with dextran method, suture line segment method and autologous thrombus method were established. To investigate the advantages and disadvantages (effectiveness, practicability, repeatability and stability) of the above three experimental methods in the establishment of acute pulmonary hypertension (APH) model. To investigate the changes of hemodynamics after acute pulmonary hypertension established by suture line segment method, 15 dogs were randomly divided into dextran group, suture line segment group and autologous thrombus group, with 5 dogs in each group. The animal model of acute pulmonary hypertension was established by injecting dextran into pulmonary artery through cardiac catheterization suture line and autologous thrombus. Right ventricular systolic blood pressure (RVSBP) was measured by cardiac catheterization. In suture line segment group, the right ventricular systolic pressure (RVSP,), pulmonary systolic pressure (PASP,), left ventricular systolic pressure (LVSP,) were measured by measuring the cardiac catheterization parameters, such as right ventricular systolic pressure (RVSP,), left ventricular systolic pressure (LVSP,). Systolic left Ventricular pressure maximum rising rate dp/dtmax-LV, Aortic systolic pressure AOSP; Use echocardiography to measure volume such as cardiac output CO, left ventricular diameter LV, right ventricular diameter RV, pulmonary artery diameter PA, aorta transAO, left ventricular end-diastolic volume EDV-LV, left ventricular ejection fraction EF-LV, Right ventricular end diastolic volume (EDV-RV,) right ventricular ejection fraction (EF-RV) was used to study hemodynamic changes. Results: the pulmonary arterial systolic pressure (PASP) of dextran method reached the peak value in 120min and decreased significantly at 180min (P0.05, the difference was statistically significant), and the mean value of standard deviation was 4.98mmHg. The suture line segment PASP reached its peak value in 120min, but decreased but not obvious in 180min, and the average standard deviation was 4.83 mm Hg. The PASP of autologous thrombus method reached the peak value in 90mmin and decreased significantly in 180mmin (P0.05, the difference was statistically significant), and the mean standard deviation was 12.12mmHg, which was significantly different from that of the two methods mentioned above. Dextran method, suture line segment method in repeatability (stability) is better than autologous thrombus method (P0.05), suture line segment method and dextran method compared with the value of the measurement no significant difference (P0.05). After the establishment of acute pulmonary hypertension model, the right ventricle and pulmonary artery dilated, aortic systolic pressure decreased slightly and cardiac output decreased slightly when pulmonary artery pressure increased moderately and right ventricular pressure load moderately increased (P0.05). In severe pulmonary hypertension, the right ventricular pressure load increased significantly, the right ventricle further dilated, the left ventricular diameter and volume decreased, and the cardiac output decreased significantly (P0.05). Conclusion: 1. Dextran method, suture line segment method and autologous thrombus method can be successfully and effectively established acute pulmonary hypertension animal model. 2. Compared with dextran method, suture line segment method is more persistent than autologous thrombus method in repeatability (stability), but the difference is not statistically significant. Suture line segment method is a simple and effective method to establish animal model of acute pulmonary hypertension and to study its hemodynamic changes. The left and right ventricle have obvious hemodynamic changes during acute pulmonary hypertension, which can be helpful for clinical evaluation and treatment decision of acute pulmonary embolism.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R543.2;R-332
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