经导管复制兔急性肠系膜动脉血栓栓塞模型的可行性研究

Feasibility study on establishment of rabbit model of acute mesenteric artery embolism through catheter

摘要:

目的 探讨经导管复制兔急性肠系膜动脉栓塞模型的方法及可行性分析。方法 新西兰大白兔20 只，随机分为模型组和对照组，两组经股动脉置入6 F 动脉鞘，模型组将自制的兔自体动脉血栓经指引导管注入肠系膜上动脉进行栓塞，血管造影证实栓塞成功后2 h 开腹观察腹腔肠管情况，行伊文思蓝染色，染色后处死动物切取标本行病理学检查。对照组只进行股动脉置管并行相应伊文思蓝染色及病理学检查。结果 ①栓塞后2 h 剖腹探查结果表明，与对照组对比，模型组栓塞肠管色泽变暗红，肠蠕动减弱或消失；对照组肠管颜色鲜红，肠蠕动正常。伊文思蓝染色观察表明，模型组栓塞肠管未着色。病理结果提示，模型组栓塞动脉供应区域肠管肠黏膜充血、局部区域出血，伴炎症细胞浸润，多数区域发生肠黏膜梗死；对照组肠管全蓝染色，无肠黏膜梗死。② D-2 聚体、肌酸磷酸激酶（CK）水平在术前、术后1 和2 h 比较，差异有统计学意义（P <0.05），术后1 h 的D-2 聚体水平高于术前，而术后2 h 低于术后1 h（P <0.05）。术后1 和2 h 的CK 水平低于术前（P <0.05），而术后1 h 与2 h 比较，差异无统计学意义（P >0.05）。结论 经导管可成功复制兔急性肠系膜动脉栓塞模型，该实验方法可控性好，成功率较高，能为急性肠系膜动脉栓塞基础研究及治疗提供可靠的动物模型。

Abstract:

Objective To explore the method and feasibility of establishing the model of acute mesenteric arterial embolism in rabbits by catheter method. Methods Twenty New Zealand White rabbits were randomly divided into embolization and control groups with 10 in each group. The rabbits in both groups were inserted with a 6 F arterial sheath through femoral artery. The blood clot was injected through the guiding catheter to the superior mesenteric artery. After 2 hours, the model group was laparotomized to observe the intestine and then stained with Evans blue. The rabbits were sacrificed after staining and the intestine specimens were cut for pathological examination. The control group was only inserted with a 6 F sheath and stained, and the intestine specimens were cut for pathological examination. Results Acute embolism of mesenteric artery model was successfully established in 8of the 10 experimental rabbits, and 7 of the 10 rabbits in the control group were successfully inserted with a sheath.After 2 hours of embolization, the intestine turned into deep red and peristalsis was inhibited or disappeared in the experimental rabbits, but there was no change in the color or peristalsis of the control group. The artery embolization region was not stained with Evans blue, while the whole intestine of the control group turned into blue. Pathological examination showed that in the artery embolization region of the experimental rabbits the mucosal congestion, local bleeding and inflammatory cell infiltration were observed; moreover, the infarction of intestinal mucous membrane was distinct. However, the pathologic changes were not observed in the control group. The changes of creatine phosphokinase (CK) and D-2 dimer of the model group before operation, 1 and 2 h after operation had significant differences (P < 0.05). The level of D-2 at 1 h after operation was significantly higher than that before operation (P < 0.05); and the D-2 dimer level 2 h after operation was significantly lower than that 1 h after operation (P < 0.05), but not statistically different from the preoperative level (P > 0.05). The levels of CK 1 and 2 h after operation were significantly lower than that before operation (P < 0.05), but there was no significant difference between 1 h and 2 h after operation (P > 0.05). Conclusions The rabbit model of acute mesenteric artery embolism can be established through catheter. This method is technically simple and the success rate is considerable. Then our method can provide a reliable animal model for the basic research and clinical therapy of acute embolism of mesenteric artery.