一种肝前性门静脉高压症模型的制备

Research on the establishment a model of prehepatic portal hypertension in dogs

目的通过门静脉主干部分结扎附加3周后脾静脉缩窄及其属支结扎的方法建立犬的动物模型,观察门静脉系统变化,为该方法能否建立一种具有脾亢的门静脉高压症大动物模型提供依据。方法实验犬25只,随机分为A组(正常组,n=5)、B组(对照组,n=10)、C组(实验组,n=10)。A组仅予以剖腹探查,B组予以门静脉主干部分结扎建立模型,C组则通过门静脉主干部分结扎附加3周后脾静脉缩窄及其属支结扎的方法建立模型,建模后术前及术后每周动态观察两组动物血象的变化,B、C组在预定时间点(术后第5、第9周)分别随机选择5只动物开腹观测门静脉自由压、脾脏大小、门体侧支循环形成情况,并切取脾脏行组织病理学检查,此外,术前及术后预定时间点了解骨髓增生情况变化。结果两种方法建模后,门静脉自由压的增高明显,血常规示B组红细胞和血小板在术后3周明显低于正常值,4周后开始回升,而C组血红细胞和血小板的下降能够持续到术后第9周,且脾脏形态变化及术后脾脏组织病理学改变和骨髓增生情况证实C组较B组能够形成良好的脾功能亢进状态。结论门静脉主干部分结扎附加3周后脾静脉缩窄及其属支结扎的方法建模后门静脉系统的变化符合门静脉高压症的表现,尤其是脾亢状态合适,具有良好的科研应用价值。

Objective To establish a new model with partial portal vein ligation at first and additional splenic vein stenosis and its collateral branches thoroughly ligated three weeks later, to observe change of the portal venous system in order to make sure whether it could establish a model of portal hypertension with hypersplenism or not. Methods Twenty-five dogs were divided into three groups： group A （normal group, n=5）, group B （control group, n=10） and group C （experimental group, n=10）. Partial portal vein ligation was proceeded in group B, in group C the model was establised by partial portal vein ligation at first and ad- ditional splenic vein stenosis combined with its collateral branches thoroughly ligated three weeks later, dogs in group A were just undergone lapboratory incision. Portal vein pressure, size of spleen the collateral circu- lation of portal vein and the fluctuation of hematocyte counts were measured and recorded at the preconcerted time. Histopathological changes of spleen and condition of bone marrow hyperplasia were examined. Results Two kinds of method of prehepatic portal hypertension developed in group B and C, the portal vein pressure increased significantly after nine weeks operating in both group B and group C. The RBC and PLT counts in group C decreased obviously compared to group A and B after nine weeks operating. The splenic histopathology changes conformed to the changes of the congestive splenomegaly, and the hyperplasia of bone marrow was much more a obvious. Conclusion This new method of establishing a model of portal hypertension is proved to be feasible, especially it can form satisfactory hypersplenism, so that it may be useful in the scientific research.