卵圆孔未闭动物模型的建立

Establishment of a porcine model of patent foramen ovale

目的探讨采用正常中华小型猪制作卵圆孔未闭动物模型的可行性。方法中华小型猪11只,选取1只行预实验,10只用于正式实验。全身麻醉下,经股静脉送入 Rups-100穿刺针系统,在透视引导下穿刺房间隔卵圆窝,然后对穿刺点行球囊扩张术。预实验动物术后1 d 处死,正式实验组动物术后21 d 处死。心脏取材,行病理检查。结果 11只猪均成功行房间隔穿刺和球囊扩张术,并经心房造影证实建立卵圆孔未闭模型。正式实验组动物除1只术中出现心包积液外,其余术中及术后均无并发症。预实验动物于处死后肉眼观房间隔卵圆窝有一0.7 cm×0.8 cm 缺损,光学显微镜下见红细胞聚集。正式实验组动物于处死后观察,7只可见房间隔卵圆窝愈合,3只分别残留0.1 cm×0.2 cm、0.2 cm×0.2 cm、0.1 cm×0.3 cm 缺损。正式实验组动物无论卵圆窝是否愈合,光学显微镜下在穿刺点周围均可见不同程度的局灶性心内膜增生和缺失、淋巴细胞聚集、心肌细胞肿胀、坏死和间质纤维化。结论采用房间隔穿刺和球囊扩张的方法,用中华小型猪建立卵圆孔未闭模型是可行的。

Objective To investigate the feasibility of developing an animal model of patent foramen ovale （PFO） in piglets by pereutaneous atrial septal puncture and balloon dilation. Methods A standardized percutaneous atrial trans-septal puncture and balloon dilation was conducted in eleven healthy piglets under general anesthesia. A Rups-100 system inserted through a femoral vein was used for the transseptal puncture, and subsequent balloon dilatation was performed at the puncture site to imitate a PFO. Euthanasia and autopsy were performed on day-1 in 1 piglet （early autopsy）, and on day-21 in the remaining 10 piglets （ late autopsy）. Results Artificial PFO was successfully created in all piglets and verified by fluoroscopy. No major technical difficulty or complication was encountered except in one which developed mild hemoperieardium In the piglet which had early autopsy, the artificial foramen was measured 0. 8 cm × 0. 7 cm in cross-section and aggregates of erythrocytes were revealed over its rim under light microscopy. In the late autopsy group （n = 10）, 7 piglets had the created forarnens healed and sealed off; while the other 3 showed relatively small residual lumens measuring 0. 1 cmx 0. 2cm, 0. 2 cm × 0. 2 cm and 0. 1 cm × 0. 3 cm in cross-section respectively. Histological examination of specimens from the late autopsy group showed variable neointima hyperplasia, loss of neointima, infiltration of lymphocytes, focal hydropic degeneration of cardiac muscle, and focal fibrosis of interstitium at the immediate vicinity of regardless of the course of healing Conclusion Artificial creation of PFO in piglets is feasible by pereutaneous atrial septal puncture and balloon dilation. This protocol may serve as a research model for PFO-related stroke in human.