【摘要】：目的：利用豬胰彈力蛋白酶局部消化誘導(dǎo)法制作類似人顱內(nèi)動(dòng)脈瘤特點(diǎn)的兔頸總動(dòng)脈梭形動(dòng)脈瘤模型。觀察該梭形動(dòng)脈瘤模型的形態(tài)學(xué)改變和早期病理學(xué)變化，探討梭形動(dòng)脈瘤的形成機(jī)制，為梭形動(dòng)脈瘤的治療尋找新的切入點(diǎn)。 方法：應(yīng)用簡(jiǎn)單手術(shù)方法結(jié)合豬胰彈性蛋白酶消化兔右側(cè)局部頸總動(dòng)脈制作梭形動(dòng)脈瘤模型，7d、14d、21d分別行DSA檢測(cè)、HE染色、彈力纖維染色等研究觀察該梭形動(dòng)脈瘤模型的影像學(xué)和組織學(xué)變化。 結(jié)果：①DSA造影顯示正常對(duì)照組血管直徑（1.64±0.17mm）；生理鹽水對(duì)照組血管直徑（1.66±0.24mm）；7d動(dòng)脈瘤的長(zhǎng)徑（19.33±1.65mm），，寬徑（2.86±0.21mm）；14d動(dòng)脈瘤長(zhǎng)徑（19.66±1.18mm），寬徑（3.95±0.54mm）；21d動(dòng)脈瘤長(zhǎng)徑（19.84±0.82mm），寬徑（4.03±0.95mm）。②HE染色觀察發(fā)現(xiàn)7d的梭形動(dòng)脈瘤血管壁失去正常血管結(jié)構(gòu)，外表面凹凸不平，由少細(xì)胞成分的外膜結(jié)締組織構(gòu)成，中膜平滑肌結(jié)構(gòu)絮亂，細(xì)胞形態(tài)扭曲；14d梭形動(dòng)脈瘤瘤壁輕度增生，內(nèi)膜較平滑，瘤體部較薄，由少細(xì)胞成分的外膜構(gòu)成，內(nèi)膜沿瘤頸交界處輕度增生，主要為膠原成分，無內(nèi)皮樣結(jié)構(gòu)；21d梭形動(dòng)脈瘤瘤壁增生明顯，內(nèi)膜較光滑完整，瘤體部?jī)?nèi)膜增生明顯并趨于穩(wěn)定，組織較疏松，含較多平滑肌細(xì)胞及膠原成分。③彈力纖維染色顯示7d的梭形動(dòng)脈瘤模型彈力層明顯變薄，瘤壁殘存部分?jǐn)嗔训膹椓w維；14d梭形動(dòng)脈瘤模型正常血管與動(dòng)脈瘤交界處彈力層逐漸變��；21d從梭形動(dòng)脈瘤模型正常血管與動(dòng)脈瘤從交界處始彈力層基本穩(wěn)定。 結(jié)論：利用簡(jiǎn)單外科手術(shù)方法結(jié)合豬胰彈性蛋白酶消化局部血管壁，可以建立形態(tài)學(xué)與人顱內(nèi)動(dòng)脈瘤相似的梭形動(dòng)脈瘤模型，且動(dòng)脈瘤模型與人顱內(nèi)動(dòng)脈瘤組織學(xué)上相似。
[Abstract]:Aim: to establish a rabbit common carotid artery fusiform aneurysm model similar to human intracranial aneurysm by local digestion of porcine pancreatic elastase. The morphological changes and early pathological changes of the fusiform aneurysm model were observed and the formation mechanism of fusiform aneurysm was discussed in order to find a new entry point for the treatment of fusiform aneurysm. Methods: the model of fusiform aneurysm was made by simple operation combined with porcine pancreatic elastase digestion of the right common carotid artery. DSA and HE staining were performed on the 14th day and 21st day after 7 days. The imaging and histological changes of the fusiform aneurysm model were observed by elastic fiber staining. Results: the diameter of 1DSA was (1.64 鹵0.17mm) in normal control group, (1.66 鹵0.24mm) in saline group, (19.33 鹵1.65mm) and (2.86 鹵0.21mm) in 7-day aneurysm, (19.66 鹵1.18mm) and (3.95 鹵0.54mm) in 14d aneurysm. The long diameter of the aneurysm (19.84 鹵0.82mm) and the wide diameter (4.03 鹵0.95mm) were observed on the 21st day. 2HE staining showed that the wall of the fusiform aneurysm lost its normal vascular structure at 7 days, the outer surface was rugged and composed of connective tissue of the outer membrane with few cell components, and the structure of the medial smooth muscle was disorderly. On the 14th day, the wall of the fusiform aneurysm was slightly proliferated, the intima was smooth, the tumor was thin and composed of the outer membrane with less cell components, and the intima proliferated slightly along the junction of the neck of the tumor, mainly composed of collagen with no endothelium-like structure. At 21 days, the wall of the spindle aneurysm was obviously proliferated, the intima was smooth and intact, the intimal hyperplasia of the tumor was obvious and tended to be stable, and the tissue was looser. There were more smooth muscle cells and collagen components. 3 Elastic fiber staining showed that the elastic layer of fusiform aneurysm model became thinner obviously after 7 days, and some broken elastic fibers remained in the wall of the aneurysm. The elastic layer at the junction between the normal vessel and the aneurysm gradually thinned on the 14th day, and the elastic layer at the junction between the normal vessel and the aneurysm on the 21st day after the spindle aneurysm model became stable. Conclusion: a fusiform aneurysm model similar to that of human intracranial aneurysm can be established by using simple surgical method combined with porcine pancreatic elastase to digest the local vascular wall, and the aneurysm model is histologically similar to that of human intracranial aneurysm.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743

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