大鼠左全肺切除致右心室重塑的研究-第三军医大学学报.doc

大鼠左全肺切除致右心室重塑的研究 罗锋（400013，重庆 重庆市中山医院胸外科） [摘要] 目的：探讨大鼠左全肺切除术后余肺高血流量及缺氧是否导致肺动脉高压发生，进而导致右心室重塑，以及其可能的发生机制。方法：健康雄性SD大鼠24只，分为2组：实验组（n=12）大鼠行左全肺切除术，对照组（n=12）大鼠行假手术。术后饲养12周后用右心导管法测定平均肺动脉压（mPAP）；检测大鼠动脉血氧分压；检测右心室肥大指数即右心室/（左心室+室间隔）[right ventricle/left ventricle+septum, RV/（LV+S）]比值；光镜下观察及测量心肌细胞及小动脉形态学变化。结果：实验组大鼠mPAP及RV/（LV+S）明显高于对照组[mPAP：(31.91±1.98) mmHg vs(17.82±1.94) mmHg, RV/（LV+S）：(及0.249±0.024) vs (0.225±0.015) P＜0.01）；]，血氧分压明显低于对照组[（77.46±5.36）mmHg vs（90.39±6.02）mmHg，P＜0.01]，心肌细胞直径明显大于对照组[（25.55±1.95）μm vs （15.55±1.75）μm， P＜0.01]），心肌小动脉管壁厚度与外径的比值明显高于对照组（P＜0.01），心肌小动脉管壁面积与血管总面积的比值明显高于对照组（P＜0.01）；实验组大鼠RV/（LV+S）与mPAP呈正直线相关（r=0.879，P＜0.01），mPAP与血氧分压呈负直线相关（r=-0.862，P＜0.01）。结论：大鼠左全肺切除术后余肺高血流量及缺氧可使肺动脉压力升高，进而导致心肌小动脉增生、右心室肥大即心室重塑。 [关键词] 心室重塑，；血管重塑，；肺动脉高压，；全肺切除术，；大鼠 The Experimental Study Of Right Ventricular Remodeling Induced By Left Pneumonectomy [Abstract]Objective: To investigate the effect and mechanism of high pulmonary blood flow and hypoxia in right ventricular remodeling induced by left pneumonectomy in rats. Methods: Twenty-four male SD rats were randomly divided into two groups: Experimental group (left pneumonectomy, n=12); Control group(sham operation, n=12).After 12 weeks of feeding, mean pulmonary arterial pressure(mPAP) of each rat were evaluated by using a right cardiac catheterization procedure. Partial pressure of oxygen in artery were detected. The ratio of right ventricular mass to left ventricle plus septum(RV/LV+S) were calculated. The change of myocardial cell and myocardial arteriole were observed. Results: Compared with Control group, mPAP and RV/(LV+S) elevated obviously in Experimental group (P0.01). The partial pressure of oxygen in artery in Experimental group is lower than that in Control group (P0.01). The diameters of myocardial cell were obviously bigger in Experimental group than that in Control group (P0.01). Compared with Control group, the ratio of myocardial arteriolar medial thickness to external diameter and medial area to total arter