不同急性肺动脉高压模型的建立及其血流动力学转归的实验研究
发布时间：2018-12-19 07:26
【摘要】：目的：1.建立葡聚糖法、缝线线段法和自体血栓法急性肺动脉高压动物模型2.探讨上述3种实验方法建立急性肺动脉高压模型的优劣(有效性、实用性、可重复性和稳定性)3.探讨缝线线段法建立急性肺动脉高压后血流动力学的变化 方法：实验犬15只,随机分成葡聚糖法组、缝线线段法组和自体血栓法组,每组5只。通过心导管经肺动脉内注射葡聚糖、缝线线段、自体血栓建立相应急性肺动脉高压动物模型。心导管测量右心室收缩压评估各实验方法优劣,在缝线线段法组中通过测定心导管各压力指标如右室收缩压RVSP、肺动脉收缩压PASP、左室收缩压LVSP、收缩期左室压力最大上升速率dp/dtmax-LV、主动脉收缩压AOSP;使用超声心动图测量容量指标如心输出量CO、左室内径LV、右室内径RV、肺动脉内径PA、主动脉内经AO、左室舒张末容积EDV-LV、左室射血分数EF-LV、右室舒张末容积EDV-RV、右室射血分数EF-RV研究血流动力学变化。 结果：葡聚糖法肺动脉收缩压(PASP)于120min达到峰值,在180min时有明显下降(P0.05,差别有统计学意义),标准差的均值为4.98mmHg；缝线线段法PASP于120min达到峰值,在180min有下降但不明显,标准差的均值为4.83mmHg；自体血栓法PASP于90mmin达到峰值,在180mmin有明显降低(P0.05,差别有统计学意义),标准差的均值为12.12mmHg,较上述两种方法有显著差异。葡聚糖法、缝线线段法在可重复性(稳定性)上优于自体血栓法(P0.05),缝线线段法与葡聚糖法比较该测值差异无统计学意义((P0.05)。急性肺动脉高压模型建立后,在肺动脉压中度增高,右室压力负荷中度增重时,右室和肺动脉扩张,主动脉收缩压略减低,心输出量轻度下降((P0.05)；重度肺动脉高压时,右室压力负荷重度增重,右室进一步扩张,左室内径及容量减少,心输出量严重降低(P0.05)。 结论：1.葡聚糖法、缝线线段法和自体血栓法均可成功有效的建立急性肺动脉高压动物模型。2.葡聚糖法、缝线线段法在可重复性(稳定性)上优于自体血栓法,缝线线段法与葡聚糖法比较具有更好的持久性,但其差异无统计学意义。3.缝线线段法是建立急性肺动脉高压动物模型及研究其血流动力学变化简便有效的方法。急性肺动脉高压时左右心室均有明显的血流动力学变化,可为急性肺栓塞的临床评估和治疗决策提供帮助。
[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.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R543.2;R-332
本文编号：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.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R543.2;R-332
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