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目的 探索新型巴马小型猪颈总动脉狭窄模型的建立方法并评价其模型建立(简称建模)的效果.方法 以9只广西巴马小型猪为研究对象,8只实验猪术前给予高脂、高盐饲料喂养,并于喂养8周后在全身麻醉下经股动脉入路采用活组织检查(简称活检)钳损伤颈总动脉内膜的方法构建动脉狭窄模型,术后继续给予高脂、高盐饲料喂养;另1只为空白对照猪.于入组时、喂养8周,以及术后6、12、18和24周进行实验猪体质量、血总胆固醇(TC)及血三酰甘油(TG)的检测并观察变化.在术后24周应用数字减影血管造影(DSA)评估实验猪颈总动脉狭窄形成情况并测量血管的最大狭窄率;应用血管内超声(IVUS)和光学相干断层扫描成像(OCT)分别对狭窄处管腔内部进行观察并测算血管管腔阻塞程度和内膜增生面积;对9只小型猪处死后标本组织进行病理学检查,观察内膜增生情况和病理学特点.结果 入组后实验猪体质量逐渐增加(F=977.97,P＜0.001);TC和TG水平于喂养8周后显著升高(均P＜0.05),之后趋于稳定.术后24周DSA证实8只实验猪颈总动脉狭窄模型全部建模成功,最大狭窄率为(55.63±10.89)％;IVUS与OCT均证实狭窄处血管内膜明显增生,测得的血管内膜增生面积[分别为(6.84±1.14)mm2和(7.13±1.27)mm2]和血管管腔阻塞程度[分别为(58.38± 10.72)％和(59.88±9.36)％]的差异均无统计学意义(t值分别为-0.48和-0.30,P值分别为0.641和0.770).建模成功实验猪血管的组织病理学检查显示,管腔狭窄为明显增生的血管内膜所致,并可见部分内弹力膜断裂,增生内膜以平滑肌细胞、胶原纤维及蛋白聚糖沉积为主,其中胶原成分显著多于蛋白聚糖成分.结论 通过高脂、高盐饲料喂养联合血管内钳夹活检损伤颈总动脉内膜的方式可成功建立巴马小型猪颈总动脉狭窄模型,其操作相对简便和安全.

Objective To explore the establishment method of a new Bama mini-piglet common carotid artery stenosis model and to evaluate the effect of its model establishment(referred to as modeling).Methods Nine Guangxi Bama mini-piglets were used as the research subjects.Eight experimental pigs were fed with high-fat and high-salt diets before surgery.After 8 weeks of feeding,intra-carotid artery biopsy was performed under general anesthesia via the femoral artery approach.The stenosis model was established by clamping the tunica intima with intravascular biopsy forceps.After the operation,the pigs were fed with high-fat and high-salt diets;the other pig was a blank control pig.The body weight,blood total cholesterol(TC)and blood triglyceride(TG)of the experimental pigs were measured at the time of enrollment,after 8 weeks of feeding,and at the 6th,12th,18th and 24th week after surgery,and changes were observed.At the end of 24 weeks after surgery,digital subtraction angiography(DSA)was used to evaluate the stenosis formation of the experimental pig common carotid artery and measure the maximum stenosis rate of the blood vessel.Intravascular ultrasound(IVUS)and optical coherence tomography(OCT)were used to detect stenosis.The inside of the lumen was observed and the degree of obstruction of the vascular lumen and the area of intimal hyperplasia were measured.The tissue specimens of 9 mini-piglets were sacrificed for pathological examination to observe the intimal hyperplasia and pathological characteristics.Results After enrollment into the study,the body weight of the experimental pigs gradually increased(F=977.97,P＜0.001).TC and TG increased significantly at the end of the 8th week of feeding(both P＜0.05),and then tended to be stable.At the end of 24 weeks after surgery,DSA confirmed that all 8 experimental pig common carotid artery stenosis models were successfully constructed,with a maximum stenosis rate of(55.63±10.89)％.Both IVUS and OCT confirmed significant proliferation of the vascular intima at the stenosis.There was no statistically significant difference in the intimal hyperplasia area measured(6.84±1.14 mm2 and 7.13±1.27 mm2 respectively)and the degree of vascular lumen obstruction[(58.38±10.72)％and(59.88±9.36)％respectively](t values:-0.48 and-0.30 respectively;P values:0.641 and 0.770 respectively).Histopathological examination of the modeled blood vessels showed that the lumen stenosis was caused by the obvious proliferation of the vascular intima,and part of the internal elastic plate was broken.The hyperplastic intima was mainly composed of smooth muscle cells,collagen fibers and proteoglycan deposition,of which collagen fibers were significantly more than proteoglycans.Conclusions The Bama mini-piglets common carotid artery stenosis model can be successfully established by feeding high-fat and high-salt diets combined with intravascular biopsy forceps to injure the intima of the common carotid artery.The operation is relatively simple and safe.