本文關(guān)鍵詞： 動物模型 頸總動脈粥樣硬化 易損斑塊 內(nèi)膜面積 放射性核素顯像　出處：《蘇州大學(xué)》2009年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的:一、通過介入球囊損傷聯(lián)合高脂飲食建立兔頸總動脈粥樣硬化易損斑塊模型。 二、利用正電子發(fā)射計算機斷層顯像儀(PET)檢測斑塊內(nèi)巨噬細(xì)胞對~(18)F-FDG的攝取,并與病理結(jié)果進行對照研究,評價PET無創(chuàng)檢測頸總動脈粥樣硬化易損斑塊的價值。 材料與方法: 一、建立動物模型:18只新西蘭大白兔隨機分成實驗組(15只)和對照組(3只)。兩組動物首先高脂飼料(含2%膽固醇)適應(yīng)性喂養(yǎng)1周,其后實驗組經(jīng)右側(cè)股動脈入路使用不可脫球囊損傷右側(cè)頸總動脈中段,并飼喂相同的高脂飼料16周;對照組繼續(xù)單純飼喂相同的高脂飼料16周。 二、數(shù)字減影血管造影(DSA)檢查:實驗組于球囊損傷后16周經(jīng)左側(cè)股動脈入路行頸總動脈數(shù)字減影血管造影,檢測血管狹窄情況(血管狹窄度＞30%、狹窄段長度＞1.0cm為建模成功必要條件);對照組同期進行血管造影檢查。 三、正電子發(fā)射計算機斷層顯像(PET)檢查:雙側(cè)頸總動脈CTA檢查,明確血管解剖位置。靜脈注射~(18)F-FDG(1.0mCi/kg)180min后,兩組動物行雙側(cè)頸總動脈PET顯像,檢測右側(cè)頸總動脈粥樣硬化斑塊層面雙側(cè)頸總動脈感興趣區(qū)(ROI)的最大標(biāo)準(zhǔn)化攝取值(SUVmax),計算靶/非靶攝取比值(T/NT)。 四、血脂測定:實驗組動物分別于高脂喂養(yǎng)前、球囊損傷后即刻和球囊損傷后16周這3個時間點測定血脂水平。對照組與實驗組在相同時間點檢測血脂。 五、病理檢查:處死實驗動物,分離實驗側(cè)頸總動脈靶區(qū)和對照側(cè)及對照組頸總動脈中段,常規(guī)HE染色,計算血管內(nèi)膜的面積。實驗組雙側(cè)頸總動脈血管內(nèi)膜面積與PET檢查獲得的SUVmax進行相關(guān)分析。 結(jié)果: 一、本實驗成功建立10只兔頸總動脈中段粥樣硬化易損斑塊模型,建模成功率為66.7%(10/15)。實驗組動物1只死于感染,4只動物右側(cè)頸總動脈血管造影不符合本實驗血管狹窄條件的要求。 二、數(shù)字減影血管造影(DSA)檢查:實驗組右側(cè)頸總動脈血管造影顯示為顯著的偏心性狹窄,平均狹窄率為(59.57±17.51)%,實驗組左側(cè)頸總動脈及對照組雙側(cè)頸總動脈血管未見狹窄。 三、正電子發(fā)射計算機斷層顯像(PET)檢查:實驗組兔右側(cè)頸總動脈靶區(qū)SUVmax顯著高于左側(cè)相應(yīng)區(qū)域(右側(cè)SUVmax:0.82±0.42,左側(cè)SUVmax:0.66±0.38,T/NT=1.62:1),配對樣本的t檢驗顯示實驗組雙側(cè)頸總動脈SUVmax具有顯著差異(t=2.927,v=59,P＜0.05)。對照組雙側(cè)頸總動脈相應(yīng)區(qū)域SUVmax無顯著差異(右側(cè)SUVmax:0.59±0.13,左側(cè)SUVmax:0.62±0.20)。 四、血脂檢測:高脂喂養(yǎng)后,實驗組與對照組的血脂濃度無明顯差異。 五、病理檢查:實驗組右側(cè)頸總動脈靶區(qū)病理染色表現(xiàn)符合動脈粥樣硬化易損斑塊的病理學(xué)特征表現(xiàn),其內(nèi)可見廣泛分布的巨噬細(xì)胞及其形成的泡沫細(xì)胞,血管內(nèi)膜明顯增厚。動脈粥樣硬化斑塊內(nèi)膜面積和PET檢查SUVmax具有正相關(guān)關(guān)系(r=0.443,P＜0.05)。 結(jié)論: 一、采用3mm球囊介入擴張新西蘭大白兔頸總動脈中段聯(lián)合高脂飲食可以建立兔頸總動脈粥樣硬化易損斑塊模型,建模成功率較高。 二、~(18)F-FDG PET無創(chuàng)檢測動脈粥樣斑塊的穩(wěn)定性具有一定的可行性。這種非侵入性的影像技術(shù)有可能在臨床上用作動脈粥樣斑塊導(dǎo)致缺血性腦血管病的風(fēng)險評估。
[Abstract]:Objective: to establish a rabbit carotid atherosclerotic plaque model by interventional balloon injury combined with high fat diet.
Two, we detected the uptake of ~ (18) F-FDG in plaque by positron emission computed tomography (PET) and compared with pathological findings, and evaluated the value of PET in non-invasive detection of vulnerable plaques of carotid atherosclerosis.
Materials and methods:
An animal model: 18 rabbits were randomly divided into experimental group (15 rats) and control group (3). Two groups of animal first high fat diet (containing 2% cholesterol) fed for 1 weeks, then the experimental group through the right femoral artery approach using detachable balloon injury in the right carotid artery the same, and fed with high fat diet for 16 weeks; the control group to continue feeding the same high-fat diet for 16 weeks.
Two, digital subtraction angiography (DSA) examination: in the experimental group 16 weeks after balloon injury of the left femoral artery approach for carotid artery DSA, vascular stenosis (stenosis degree of stenosis length > 30%, > 1.0cm for modeling the necessity of success); the control group at the same time of angiography.
Three, positron emission tomography (PET) examination: bilateral carotid artery CTA examination, clear vascular anatomy. Intravenous injection of ~ (18) F-FDG (1.0mCi/kg) 180min, two groups of animal by bilateral carotid artery PET imaging detection of right carotid atherosclerotic plaque level bilateral carotid artery region of interest (ROI) the maximum standard uptake value (SUVmax), calculate the target / non target uptake ratio (T/NT).
Four, blood lipid determination: the experimental group animals were measured before and after 16 weeks of balloon injury and 3 weeks after the high fat diet. The blood lipid level was detected at the same time points in the control group and the experimental group at the same time point.
Five, pathological examination: the experimental animals were sacrificed, the common carotid artery target area and the control group were separated from the experimental common carotid artery, and the area of intima was calculated by routine HE staining. The intimal area of bilateral common carotid artery in the experimental group was correlated with the SUVmax obtained by PET.
Result:
First, the atherosclerotic plaque models of 10 rabbits were successfully established in this experiment. The success rate of atheromatous plaque was 66.7% (10/15). 1 of the animals in the experimental group died of infection. The right common carotid artery angiography in 4 animals did not meet the requirements of the experimental vascular stenosis.
Two, digital subtraction angiography (DSA): in the experimental group, the right carotid artery angiography showed a significant eccentric stenosis, with an average stenosis rate of (59.57 + 17.51)%. There was no stenosis in both the left common carotid artery and the control group.
Three, positron emission tomography (PET) examination: the right carotid artery of rabbits in group SUVmax were significantly higher than that of the corresponding target area (left right left SUVmax:0.82 + 0.42, SUVmax:0.66 + 0.38, T/NT=1.62:1), paired samples t test showed that the experimental group of bilateral carotid artery SUVmax with significant difference (t=2.927, v=59, P. "0.05). The control group of bilateral common carotid arteries of the corresponding region of SUVmax had no significant difference (right SUVmax:0.59 left SUVmax:0.62 + 0.13, + 0.20).
Four, blood lipid test: after high fat feeding, there was no significant difference in the blood lipid concentration between the experimental group and the control group.
Five, pathological examination: the experimental group of right carotid artery pathological staining pathology with target vulnerable atherosclerotic plaque characteristics, widely distributed in the macrophages and the formation of foam cells, intimal thickening. Atherosclerotic plaque intima area and PET examination of SUVmax had a positive correlation (r=0.443, P < 0.05).
Conclusion:
First, using 3mm balloon intervention to expand the middle common carotid artery and high fat diet of New Zealand white rabbits can establish a rabbit carotid atherosclerosis vulnerable plaque model, and the successful rate of modeling is high.
Two, ~ (18) F-FDG PET is feasible for non-invasive detection of atherosclerotic plaque stability. This non-invasive imaging technology may be used as a risk assessment for ischemic cerebrovascular disease in atherosclerotic plaque clinically.

【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2009
【分類號】：R-332;R817

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