使用血管吻合轮建立兔动脉旁路移植模型

Rabbit artery bypass grafting model by using vascular anastomosis wheel

目的 使用血管吻合轮建立一种接近临床且易于操作的动脉旁路移植动物模型.方法 取新西兰大白兔15只,体质量2.5～3.5 kg,使用血管吻合轮将颈静脉与颈动脉行端端吻合,术后即刻以及术后2个月行颈动脉超声及流量检查,并通过形态学、病理学分析判断动静脉吻合口通畅情况及移植静脉内膜增生情况.结果 14只兔成功建立旁路移植模型,1只死于麻醉过深导致的呼吸抑制.术后即刻静脉旁路血管的流量与正常颈动脉比较有显著下降[（50.81±1.33） ml/min对（70.59 ＆#177;0.68）ml/min,P＜0.01],且搏动指数（pulsatile index,PI）值显著升高（2.15±0.07对1.22±0.04,P＜0.01）;术后2个月静脉旁路血管的流量显著小于术后即刻静脉旁路血管流量[（27.46 ±2.15） ml/min对（50.81±1.33）mi/min,P＜0.01];术后2个月静脉旁路血管与正常颈静脉的内膜比较显著增厚[（160.30±1.78） μm对（49.06 ±2.76） μm,P＜0.01];静脉旁路血管弹力板的数目与正常颈静脉比较显著增加（12.36±0.25对3.21±0.15,P＜0.01）.结论 使用血管吻合轮建立动脉旁路移植模型可成功模拟人冠状动脉旁路移植术后静脉旁路血管的病理变化,可为冠状动脉旁路移植术后静脉旁路血管多方面研究提供理想的实验模型.

Objective To establish a close clinical and easy to operate animal artery bypass grafting model by using vascular anastomosis wheel.Methods 15 rabbits that weighted 2.5-3.5 kg were studied.Each animal underwent an end-toend anastomosis of jugular vein and carotid artery by vascular anastomosis wheel.Carotid ultrasound and flow detection were taken immediately and 2 months after surgery respectively,as well as morphology and pathology were recorded to analyze and evaluate the intimal hyperplasia of vein graft and arteriovenous anastomotic site.Results 14 rabbits were successfully established CABG model,however 1 rabbit died of respiratory inhibition caused of excessive anesthesia.Compared with normal carotid artery,the vein bridge showed significantly lower blood flow [（50.81± 1.33） ml/min vs.（70.59± 0.68） ml/min,P 〈0.01,higher PI（2.15±0.07vs.1.22 ±0.04,P 〈0.01）] immediately after surgery.Compared with the vein grafts immediately after surgery,the vein grafts 2 months after surgery showed significantly lower blood flow [（27.46 ＆#177; 2.15） ml/min vs.（50.81 ± 1.33） ml/min,P 〈 0.01].Compared with normal jugular vein,the vein grafts 2 months after surgery showed significantly higher intimal hyperplasia[（160.30± 1.78） μm vs.（49.06 ± 2.76） μm,P 〈 0.01],and higher number of elastic plates（12.36 ± 0.25vs.3.21 ± 0.15,P 〈 0.01）.Conclusion The use of vascular anastomosis wheel to establish an artery bypass graft model can imitate the pathological changes of vein grafts after CABG,which can provide an ideal animal model for various researches on vein grafts.