胶原诱导性关节炎小鼠升主动脉弹性变化及与血清炎性因子的关系

目的 观察胶原诱导性关节炎(collagen-induced arthritis, CIA)小鼠升主动脉组织病理、超声弹性参数及血清炎性因子水平变化,探讨CIA小鼠升主动脉超声弹性参数与血清炎性因子的相关性。方法 雄性DBA/1小鼠7只为CIA组,制备CIA模型;野生型雄性C57BL/6小鼠7只为对照组。造模第56天,测量2组小鼠收缩压、舒张压;行超声检查测量收缩期和舒张期升主动脉内径,计算升主动脉超声弹性参数包括升主动脉应变率、膨胀系数、僵硬指数。然后处死小鼠左心室取血,采用ELISA法检测血清白细胞介素-1β、肿瘤坏死因子-α、类风湿因子水平;取升主动脉组织采用HE染色和van Gieson染色观察主动脉管壁病理变化。采用Pearson相关法分析CIA小鼠升主动脉超声弹性参数与血压、血清炎性因子水平的相关性。结果 (1)CIA组舒张压[(54.50±4.79)mm Hg]、升主动脉应变率[(11.66±2.68)%]、膨胀系数[(0.91±0.15)×10^(-6)cm^(2)/dyn]均低于对照组[(59.47±3.33)mm Hg、(14.90±2.31)%、(1.20±0.26)×10^(-6)cm^(2)/dyn](P<0.05),收缩压[(99.55±3.82)mm Hg]、僵硬指数(6.08±1.99)及血清白细胞介素-1β[(15.62±1.57)ng/L]、肿瘤坏死因子-α[(28.16±6.10)ng/L]、类风湿因子[(109.36±12.23)u/mL]水平均高于对照组[(94.56±2.49)mm Hg、3.38±1.02、(3.42±1.3)ng/L、(6.40±2.65)ng/L、(12.61±2.98)u/mL](P<0.05),收缩期升主动脉内径[(1.41±0.14)mm]、舒张期升主动脉内径[(1.25±0.09)mm]与对照组[(1.51±0.11)、(1.34±0.09)mm]比较差异均无统计学意义(P>0.05)。(2)HE染色结果显示,对照组和CIA组升主动脉管壁组织结构均未见明显异常。van Gieson染色结果显示,对照组升主动脉管壁弹力纤维排列紧致、连续、着色清晰;CIA组升主动脉管壁弹力纤维排列松散、水肿、着色变淡。(3)CIA小鼠升主动脉应变率与收缩压、血清类风湿因子水平均呈负相关(r=-0.807,P<0.001;r=-0.639,P=0.014);膨胀系数与收缩压、血清类风湿因子水平均呈负相关(r=-0.833,P<0.001;r=-0.627,P=0.016),与舒张压呈正相关(r=0.772,P=0.018);僵硬指数与收缩压及血清白细胞介素-1β、血清类风湿因子水平均呈正相关(r=0.868,P=0.014;r=0.588,P=0.027;r=0.684,P=0.007),与舒张压呈负相关(r=-0.651,P=0.012)。结论 CIA小鼠升主动脉弹性降低,血清白细胞介素-1β、肿瘤坏死因子-α及类风湿因子水平升高,升主动脉超声弹性与血清炎性因子水平呈负相关。

Ventricular septal rupture and partial left ventricular posterior wall tear resulted from blunt chest trauma

Cardiac contusion and valvular injuries are the most common cardiac injuries after a blunt traumatic chestinjury.1 But ventricular septal rupture （VSR） is a rare finding after a blunt chest wall trauma.2 Here we report a 16 years old young man with no medical history who sustained a chest wall injury after a bookshelf falling on his left chest. He was hospitalized because of his chest pain and heaviness. Initial physical examination showed parasternal Ⅲ-Ⅳ systolic murmur. ECG showed a complete right bundle branch conduction blockage.