布加综合征大鼠介入治疗研究

摘要

目的 制备布加综合征(BCS)大鼠模型,探讨介入治疗的可行性.方法 清洁级雄性SD大鼠50只采用随机数字法分为模型组和对照组,各25只.模型组采用部分结扎下腔静脉(IVC)制备BCS大鼠模型,对照组仅分离IVC周围组织.术后饲养12周检测肝功能,然后行数字减影血管造影(DSA)及介入治疗,并进行肝脏病理组织学检查.结果 饲养至12周模型组存活20只(80.0％)大鼠,对照组存活22只.与对照组比较,模型组大鼠血清ALT[(43.1±5.5) U/L比(62.6±4.6)U/L]和AST[(84.7±26.5) U/L比(161.7±25.8) U/L)]升高,差异有统计学意义(P＜0.05).HE染色结果显示BCS大鼠存在明显肝细胞坏死及炎症细胞浸润,Masson染色见肝纤维化形成.DSA检查显示,模型组大鼠均存在IVC阻塞,其中14只(70.0％,14/20)在成功探查IVC阻塞段后行介入治疗.7只采用直径3.5 mm球囊扩张,6只(85.7％,6/7)扩张成功,另1只(14.3％,1/7)扩张失败;其余7只采用直径4.5 mm球囊扩张,2只(28.6％,2/7)成功,另外5只(71.4％,5/7)发生IVC破裂出血死亡.结论 采用部分结扎IVC法建立BCS大鼠模型能够很好模拟IVC阻塞型BCS患者的病变特征,且介入治疗可行性尚可,这可为该型BCS研究提供基础.%Objective To explore the feasibility of interventional therapy in rat models of Budd-Chiari syndrome (BCS).Methods A total of 50 male clean SD rats were divided into model group and control group using random number table method,with 25 rats in each group.In the model group,BCS rat model was constructed by adopting partial ligation of the inferior vena cava (IVC),and the control group only had separation of surrounding tissues of IVC.Liver function was studied 12 weeks after postoperative raising,and digital subtraction angiography (DSA) and interventional therapy were performed,coupled with liver histopathology staining.Results Twenty BCS rats survived till the 12th week of raising,with the survival rate reaching 80.0％,and 22 survived in the control group.Compared with the control group,ALT [(43.1±5.5) U/L vs.(62.6±4.6) U/L] and AST [(84.7±26.5) U/L vs.(161.7±25.8) U/L)] in serum of rats in the model group increased,the differences were statistically significant (P＜0.05).HE staining showed that obvious hepatocyte necrosis and inflammatory cell infiltration were observed in BCS rats,and liver fibrosis was spotted via Masson staining.DSA examination found IVC obstruction in the model group,among which 14 (70.0％,14/20) received interventional therapy after successful probing of IVC obstructed segment,and 7 had balloon dilatation with a diameter of 3.5 mm,with 6 (85.7％,6/7) successfully dilatatedand the other 1 (14.3％,1/7) failed;the remaining 7 had balloon dilatation with a diameter of 4.5 mm,with 2 (28.6％,2/7) successfully dilatated,and the other 5 (71.4％,5/7) died of IVC rupture.Conclusion The BCS rat models by partial ligation of IVC can well simulate the pathophysiological changes and angiopathy characteristics of IVC obstructive BCS patients,which provide a platform for the basic research of interventional therapy of BCS.