血管介入性兔肾急性节段缺血损伤模型的建立

Modeling acute segmental renal ischemia via vascular interventional in rabbits

目的探讨通过血管介入技术建立兔肾急性节段缺血损伤模型的可行性,为研究肾局部急性缺血所致病理生理改变和功能损伤提供可靠的实验学方法。方法健康新西兰大白兔10只,按随机数字法分为对照组(n=2)和栓塞组(n=6)。栓塞组行右颈总动脉置管后再行左肾下极次级肾动脉分支超选择性栓塞,对照组只行右颈总动脉置管。记录两组颈动脉置管成功率及栓塞组超选择性肾动脉栓塞的成功率。栓塞组按观察时间进一步分为栓塞后12 h组(n=2),栓塞后24 h组(n=2),栓塞后72 h组(n=2)。观察实验兔一般情况,并分别在相应时间点处死动物进行肾脏病理学检查。另有补充组2只,上述4组实验兔死亡时,随机抽取补充。结果实验兔行右颈总动脉置管均获得成功(9/9)。栓塞组1只实验兔超选择性肾动脉栓塞失败,原因为体重偏轻,靶肾动脉分支纤细,微导管进入后阻断血流。从补充组随机抽取1只实验兔补充,最终有6只实验兔成功行超选择性肾动脉栓塞,建成肾急性节段性缺血损伤模型6个,制模成功率为85.7%(6/7)。实验兔一般情况好,未出现明显并发症,均存活至实验终点。病理下被栓塞的肾组织出现急性缺血反应,早期以肾小管肿胀、变性为主,然后逐步出现弥漫或灶状的细胞崩解、脱落,最后在第3天时出现完全的肾梗死,呈现渐进的病理过程。结论通过血管介入建立兔肾急性节段缺血损伤模型的方法可行,而且重复性好,并发症少,成功率高,能较好地模拟人类肾急性局部缺血的病理生理学特点。

Objective To investigate the feasibility of modeling acute segmental renal ischemia via vascular interventional in rabbits,and to propose a reliable experimental method for studies on alterations in renal pathophysiology and functions caused by local acute ischemia.Methods Ten healthy New Zealand white rabbits were divided into control group(n=2)and embolization group(n=6)according to random number table.In the embolization group,the right common carotid artery was catheterized,and then super-selective embolization of secondary renal artery branches at the left renal lower pole was performed.The control group received right common carotid artery catheterization alone.The success rate of carotid artery catheterization in both groups and of super-selective renal artery embolization in the embolization group were recorded.The embolization group was further divided into subgroups based on duration of observation:the 12 h(n=2),24 h(n=2),and 72 h(n=2)post-embolization groups.The experimental rabbits were inspected for the general condition,and sacrificed at designated time points for renal pathological study.In addition,an alternate group of rabbits(n=2)was set and randomly selected for supplementation after sacrifice of the experimental rabbits in the four groups.Results All rabbits experienced successful catheterization of the right common carotid artery(9/9).Super-selective renal artery embolization failed in one experimental rabbit of the embolization group due to low body weight,slender branching of target renal artery,and blood flow occlusion after placement of microcatheter.One experimental rabbit was randomly selected from the alternate group for supplementation.Finally,super-selective renal artery embolization was successfully performed in six rabbits,generating six rabbit models of acute segmental renal ischemia with the successful modeling rate being 85.7%(6/7).All of the experimental rabbits presented normal general conditions without evidenced complications,and survived to the end of the experiment.Pathological examination showed acute renal ischemia in embolized renal tissue with a progressive profile which largely presented tubular swelling and degeneration during early hours,and thereafter,gradually followed by diffuse or focal cell disruption and shedding,and finally ending up with complete renal infarction on day 3.Conclusion Modeling acute segmental renal ischemia in rabbits via vascular intervention is feasible with good reproducibility,few complications and high success rate,and may well simulate the pathophysiology of acute renal ischemia in human.