夹闭腹主动脉和腰动脉的脊髓缺血再灌注损伤模型比较研究

Models of spinal cord ischemia /reperfusion injury by blocking lumbar artery versus abdominal aorta

目的脊髓缺血再灌注损伤一直是医学领域的难点,目前已有的脊髓缺血再灌注损伤的造模方法较多,制备方法一直在不断的改进,但至今尚没有一个模型能满足临床治疗的需要。文中采用血管铸型技术分析家兔脊髓血管分布,确定脊髓的血液供应情况,应用数字减影技术鉴定夹闭腹主动脉和夹闭腰动脉的脊髓缺血再灌注损伤模型,确定模拟脊髓缺血再灌注损伤的最佳模型。方法①家兔行升主动脉近心端插管后灌注铸型剂,制成动脉血管铸型标本后摄像,分析脊髓血管走形及分布规律。②夹闭腹主动脉或夹闭腰动脉造成家兔脊髓缺血再灌注损伤模型,采用数字减影技术在各时段摄像、分析、鉴定不同方法制成的模型。③取鉴定成功脊髓缺血再灌注损伤后的脊髓,行HE染色,对比分析2种模型的差异。结果①家兔动脉血管铸型标本能充分显示家兔全身动脉血管。②通过数字减影技术证实2种方法均可以造成脊髓缺血再灌注损伤。③夹闭腹主动脉组造成脊髓组织神经元肿胀,神经元间隙增大;夹闭腰动脉组脊髓组织神经元损伤较轻。结论①血管铸型技术是清晰显示家兔全身动脉的方法。②数字减影技术能成功鉴定2种模型。③夹闭腰动脉的脊髓缺血再灌注损伤模型优于夹闭腹主动脉的模型。

Objective Spinal cord ischemia/reperfusion injury （SCIRI） is a focus of research in the medical field. The methods to establish SCIRI models are varied and constantly improved, but none of them can yet satisfy the requirements of clinical treatment. This study investigated the establishment of an optimal SCIRI model in rabbits. Methods Artery casting specimens were made by injecting a casting agent into the proximal ascending aortas of rabbits followed by analysis of the run and distribution of the spi- nal cord vessels. SCIRI models were established in 12 standardized rabbits by blocking the abdominal aorta （group A） and lumbar ar-teries （group B） and identified by digital subtraction angiography. Spinal cord samples were obtained from the successfully identified SCIRI models for HE staining and analysis of the differences between groups A and B. Results The artery casting specimens clearly exhibited the systemic blood supply of the rabbits. SCIRI models were successfully made by blocking either the abdominal aorta or the lumbar artery. Swelling of and increased interspace between the neurons in the spinal cord were found in group A, and mild injury of spinal cord neurons observed in B. Conclusion Vessel casting technique can clearly reveal the systemic arterial blood supply in rab-bits. Digital subtraction angiography is a good method to identify two different SCIRI models established by blocking the abdominal aorta and lumbar arteries. The SCIRI model made by blocking the lumbar artery is better than that established by the former method.