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目的在初步建立主动脉中膜分层方法的基础上,对其层间剪应力(ISS)进行分析。方法取人升主动脉、降主动脉近段和降主动脉远段标本,分为腹侧和背侧两部分,在立体显微镜下,将主动脉组织大体均匀分层,并测定相邻两层间的周向和纵向层间剪应力。结果主动脉壁至少可分为4层。同一层间剪应力在不同部位相比较：降主动脉近段中间两层间的剪应力显著低于升主动脉(P＜0．05),内侧和外侧各层间剪应力在各部位差异无统计学意义(P＞0．05)；降主动脉近段中间两层间剪应力在腹、背侧间差异无统计学意义(P＞0．05)。同一主动脉段不同层间剪应力相比较：降主动脉近段腹侧和背侧中间两层间剪应力均显著低于内侧和外侧(P＜0．05)；降主动脉近段中间两层间剪应力在腹侧不同方向上差异无统计学意义(P＞0．05),但在背侧周向显著高于纵向,差异有统计学意义(P＜0．05)。结论人主动脉中膜可以进一步分层研究。降主动脉近段腹侧中层和背侧中层纵向均是潜在的夹层间隙容易形成的部位。
Objective To establish a method of aortic intima-media delamination based on the analysis of inter-layer shear stress (ISS). Methods The ascending aorta, proximal descending aorta and distal descending aorta were divided into two groups: ventral and dorsal. The aortic tissue was delaminated under stereomicroscope and the adjacent two layers Between the circumferential and longitudinal shear stress between layers. Results The aortic wall can be divided into at least 4 layers. The same layer of interlaminar shear stress in different parts of the comparison: near the middle of the descending aorta between the middle two layers of shear stress was significantly lower than the ascending aorta (P <0.05), medial and lateral shear stress in each part of the difference Statistical significance (P> 0.05). There was no significant difference in the shear stress between the middle two layers of the descending aorta between the abdomen and the dorsal side (P> 0.05). The shear stress in different layers of the same aorta was significantly lower than that in the medial and lateral (P <0.05). The shear stress in the middle ventral and dorsal midline of proximal descending aorta was significantly lower than that in the medial and lateral There was no significant difference in interlaminar shear stress between different directions (P> 0.05), but it was significantly higher in the dorsal side than in the longitudinal direction (P <0.05). Conclusion Human aortic tunica media can be further stratified. The proximal ventral midline and the dorsal midline of the descending aorta are all potential sites for potential dissection.