改良大鼠颈动脉内膜剥脱术模型的建立及病理形态初步观察

Establishment of Modified Rat Carotid Endarterectomy Model and Preliminary Observation on Changes of Pathological Morphology

目的 使用改良方法建立一种稳定可靠的大鼠内膜剥脱术（CEA）模型,观察术后组织形态学变化及平滑肌细胞增殖情况.方法 将48只SD大鼠分为改良组和常规组,每组24只;通过切开前穿刺血管前壁和预先留置缝线建立改良CEA模型,比较两组建模成功率及建模手术时间,HE染色观察术后3d、14d和28 d血管壁厚度动态变化,免疫组织化学方法测量不同时期血管壁增殖细胞核抗原（PCNA）表达情况.结果 成功构建改良大鼠CEA模型.改良组建模成功率（87.5％）与常规组（79.2％）比较差异无统计学意义（P=0.46）,改良组手术时间（31.2±3.7 min）显著低于常规组（40.9±4.2 min）（P=0.00）;改良组术后28 d管壁厚度（258.4±20.9 μm）较术后3 d（116.3±14.6 μm）显著增厚（P＜0.01）;改良组术后28 d管腔内径（309.6±32.8 μm）较术后3 d（602.8±40.5 μm）显著狭窄（P＜0.01）;PCNA表达在3d为稍高表达,14d为高表达,至28 d未见表达.结论 改良的大鼠颈动脉内膜切除模型成模率高,操作简单,建模手术时间短,稳定可靠,适用于CEA术后再狭窄的研究.

Objective To establish a steady and reliable rat model of carotid endarterectomy （CEA） by improved method, and to explore the changes of pathological morphology of vascular wall and prolif- eration of vascular smooth muscle cells after CEA. Methods Forty-eight SD rats were divided into two groups with 24 rats in each group （modified CEA group and conventional CEA group）. The modified model was created by puncturing the carotid artery with a thin needle and detaining sutures before a longitudinal arteriotomy was performed; The success rate of modeling and the operation time were observed to evaluate the characteristics and reliability of two models. HE staining was performed to measure dynamic changes of the thickness of the vascular walls and immunohistochemistry was used to find expression of proliferating cell nuclear antigen （PCNA） on vessel wall on 3 days, 14 days and 28 days after operation. Result The model of rat carotid endarterectomy were successfully constructed. There was no significant difference in the success rate of modeling between two groups （87.5% vs 79.2%, P=0.46）. The operation time （31.2± 3.7 min） of modified group was significantly lower than that （40.9 ±4.2 min） of conventional group （P=0.00）. Twenty-eight days after the operation, the thickness of the artery and the luminal diameter were significantly different from those of 3 days after the operation in modified group. The positive expression of PCNA was slightly higher on 3 days after operation, the highest on 14 days, and there was no positive expression on 28 days. Conclusion Modified rat carotid endarterectomy model has the characters of high success rate and simple handling, short operation time, and as a steady and reliable model, it is suitable for the study of restenosis after CEA.