小鼠心肌补片模型的建立及肺动脉高压的治疗

发布时间：2018-12-14 14:20

【摘要】：第一部分小鼠心肌补片模型的建立目的建立一种用于进行心肌修复研究的小鼠心肌补片模型。方法C57BL小鼠共60只,麻醉后行气管插管,经左侧第4肋间开胸,于左心室前侧壁行部分心肌剪除,胶原心肌补片修补,止血后逐层关胸,观察小鼠术后存活情况、术后4周心功能变化和术后1周心肌组织学检查。结果术后4周存活41只,心肌石蜡切片可见胶原补片在位,部分左心室外壁缺损,6只小鼠心功能有下降明显(EF%60%),其中5只小鼠存在心肌梗死。结论通过围手术期的操作技术和方法的改进,可以提高小鼠心肌补片模型的成功率,为心肌损伤修复研究提供了一种可供选择的模型。第二部分波生坦治疗肺动脉高压疗效和安全性的Meta分析目的评价波生坦治疗肺动脉高压的有效性与安全性。方法电子检索Cochrane对照试验注册数据库(2010年第3期)、PubMed、EMbase、CBM、CNKI(从建库至2010年9月)。评价纳入研究的方法学质量,采用RevMan 5.0软件进行Meta分析。结果共纳入7个RCT,包括714例病人。Meta分析结果显示：波生坦能够改善部分肺动脉高压患者的活动能力,降低平均肺动脉压；能够使肝功能损害发生率增高,[OR=2.35,95%CI (1.06,5.18), p=0.03],病情原因所致退出无统计学差异,[OR=0.77,95%CI (0.43,1.40), p=0.40]. 结论现有证据表明,波生坦治疗肺动脉高压有效,不增加病情原因所致退出；增加肝功能损害发生率,但停药后可改善。限于对各指标可合并的研究有限,还需要大样本、高质量的随机对照试验来进一步评价。
[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 卤5.18), p0.03]. There was no significant difference in the cause of the disease. [OR=0.77,95%CI (0.43 卤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.
【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R-332;R543.2

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