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目的探讨葡聚糖法、缝线线段法和自体血栓法建立急性肺动脉高压模型的优劣及缝线线段法造成急性肺动脉高压的血流动力学变化。方法实验犬15只,随机分成葡聚糖法组、缝线线段法组和自体血栓法组,每组5只。通过心导管经肺动脉内注射葡聚糖、缝线线段、自体血栓建立相应急性肺动脉高压动物模型。心导管测量右心室收缩压评估各实验方法优劣,在缝线线段法组中通过测定心导管各压力指标,使用超声心动图测量容量指标研究血流动力学变化。结果葡聚糖法、缝线线段法在可重复性(稳定性)上优于自体血栓法(P<0.05),缝线线段法与葡聚糖法比较该测值差异无统计学意义(P>0.05)。急性肺动脉高压模型建立后,在肺动脉压中度增高、右室压力负荷中度增重时,右室和肺动脉扩张,主动脉收缩压略减低,心输出量轻度下降(P>0.05);重度肺动脉高压时,右室压力负荷重度增重,右室进一步扩张,左室内径及容量减少,心输出量严重降低(P<0.05)。结论缝线线段法是建立急性肺动脉高压动物模型及研究其血流动力学变化简便有效的方法。急性肺动脉高压时左右心室均有明显的血流动力学变化,可为急性肺栓塞的临床评估和治疗决策提供帮助。
Objective To investigate the advantages and disadvantages of the model of acute pulmonary hypertension induced by dextran, suture and autologous thrombosis and the hemodynamic changes of acute pulmonary hypertension caused by suture line segment method. Methods Fifteen dogs were randomly divided into three groups: dextran group, suture line group and autologous thrombosis group. Acute pulmonary hypertension model was established by intracardiac injection of dextran, suture line and autologous thrombus through the cardiac catheter. Right ventricular systolic pressure measurement of cardiac catheterization The pros and cons of each experimental method in the suture line group method by measuring the cardiac catheter pressure indicators, the use of echocardiography to measure the volume index to study hemodynamic changes. Results Dextran method and suture line method were better than autologous thrombus method (P <0.05) in repeatability (stability). There was no significant difference between suture line method and dextran method (P > 0.05). After the establishment of acute pulmonary hypertension model, right ventricular and pulmonary artery dilatation, moderate aortic systolic pressure slightly decreased and cardiac output slightly decreased (P> 0.05); Pulmonary hypertension, right ventricular pressure overload, weight gain, further expansion of the right ventricle, left ventricular diameter and volume decreased, cardiac output was significantly reduced (P <0.05). Conclusion The suture line method is an effective and convenient method for establishing an animal model of acute pulmonary hypertension and studying its hemodynamic changes. Acute pulmonary hypertension in both left and right ventricular hemodynamic changes were significant, for the clinical evaluation of acute pulmonary embolism and treatment decisions to provide help.