猪胰弹力蛋白酶血管外消化法制作兔颈总动脉梭形动脉瘤

Inducing common carotid fusiform aneurysms in rabbit with the porcine pancreatic elastase extravascular digestion method

目的：探讨使用颈总动脉外膜消化法制作兔颈总动脉梭形动脉瘤的可行性和有效性。方法将16只新西兰大白兔按随机数字表法分为两组。实验组12只,使用猪胰弹力蛋白酶80~400 U孵育消化右侧颈总动脉起始点远端2~4 cm段。造模后1周行静脉血管造影,测量颈总动脉梭形膨大的宽度；取梭形扩张血管行苏木素-伊红（ HE）染色及扫描电镜观察血管病理学变化。对照组取4只新西兰大白兔,使用等渗盐水孵育颈总动脉,1周后采用同样方法观察颈总动脉管腔及内膜变化。结果实验组12只新西兰大白兔在颈总动脉外膜消化后,血管造影显示10只模型兔颈总动脉管腔呈梭形扩大,梭形动脉最宽处直径为（3．70±0．32） mm,2只出现颈总动脉闭塞,较对照组右侧颈总动脉血管直径[（1．80±0．16） mm]明显增粗（P〈0．01）；HE染色显示实验组兔右侧颈总动脉消化段管腔增宽,外膜及中膜减少；扫描电镜显示实验组兔颈动脉内膜炎性损伤及血栓附着。结论使用猪胰弹力蛋白酶消化颈总动脉外膜可以使兔颈总动脉呈梭形扩张,并造成颈动脉内膜损伤。使用此方法能够有效制作出梭形动脉瘤模型,具有一定的可行性。

Abstract： Objective To investigate the feasibility and effectiveness of inducing rabbit common carotid fusiform aneurysms via the common carotid extravaseular digestion method. Methods Sixteen New Zealand white rabbits were randomly assigned into either an experiment group （n = 12 ） or a control group （ n = 4）. Porcine pancreatic elastase 80 -400 U were used to incubate and digest 2 to 4 cm segment of artery distal to the origin of right common carotid artery. One week after modeling, intravenous angiography was performed and the length and width of fusiform dilatation of common carotid artery were measured. The fusiform dilated artery was examined with hematoxylin and eosin staining and the vascular morphological changes were observed with scanning electron microscope. Isotonic saline solution was used to incubate common carotid arteries of the 4 New Zealand white rabbits in the control group. After one week, the same method was used to observe the lumen of common carotid artery and intimal changes. Results After the digestion of common carotid artery adventitia, the angiography of 12 New Zealand white rabbits of the experimental group revealed fusiform dilatation of common carotid artery of the 10 model rabbits. The widest diameter of the fusiform artery was 3.70 ± 0. 32 mm; two rabbits had common carotid arteryocclusion. Compared with the control group, the right common carotid artery diameter enlarged significantly in the experimental group （1.80±0.16 mm,P 〈0.01 ）. The HE staining showed that the lumen widened, adventitia and media reduced. Scanning electron microscope showed intimal inflammatory injury and thrombus attachment. Conclusion Using porcine pancreatic elastase to digest the adventitia of common carotid artery can make fusiform dilatation of common carotid artery in rabbits. Using this method may effectively induce a model of fusiform aneurysm,and it has certain feasibility.