【作者】 李涛；

【导师】 余绍祖；

【作者基本信息】 武汉大学 ， 内科学， 2004， 博士

【摘要】 第一部分 目的：探讨兔颈内动脉系统的结构和变异的类型，从而建立一种新的兔大脑中动脉梗死模型。 方法：新西兰白兔40只，20只制作脑血管模型；20只制作大脑中动脉梗死模型。0.6号渔线经颈内动脉插至大脑中动脉起始部，观察血压、颅内压、脑温、中心静脉压和股动脉压，48h后MRI扫描，过量麻醉处死，取脑进行TTC染色。 结果：新西兰白兔颈内动脉有2种变异，一是颈总动脉近心端发出第一分支为颈内动脉，向头部移行4.2～4.8cm后到达大脑中动脉起始部(85％)，二是颈内动脉在入颅前先分出供应耳后部的血管分支，其主干入颅后形成大脑中动脉起始部(15％)。线栓大脑中动脉后，兔的血压、颅内压逐渐升高，48h后MRI扫描和TTC染色均可见梗死灶，其大小、部位基本一致。 结论：线栓法制作兔大脑中动脉梗死模型操作简单，创伤小，制作的模型稳定，成功率高。 第二部分 目的：探讨低温液体(4℃)经外周静脉灌注对家兔局灶性脑缺血的保护作用。 方法：30只家兔制成大脑中动脉梗死模型后，随机分成3组：对照组(Ⅰ组)、体表冰袋降温组(Ⅱ组)和低温液体(4℃)外周静脉灌注组(Ⅲ组)。将脑温降至(34.5±0.5)℃，并维持24 h。检测脑温(TC)、颅内压(ICP)、脑灌注压(CPP)和中心静脉压(CVP)等指标。 结果：两低温组脑温降至35℃用时分别为(48.0±7.1)min(Ⅱ组)和(52.3±8.9)min(Ⅲ组)，两组间无显著差异(P＞0.05)。Ⅱ组亚低温前ICP为12.8±2.9mmHg，亚低温12h后降至10.1±1.8mmHg，24h后降至9.2±1.5mmHg；亚低温前CPP为74.7±6.0mmHg，2h后升至75.0±5.6mmHg、12h后升至75.9±3.2mmHg，24h后升至76.0±5.1mmHg。Ⅲ组亚低温前ICP为12.5±2.2mmHg，亚低温12h后降至11.0±2.2mmHg，24h后降至10.5±2.0mmHg；亚低温前CPP为75.9±6.2mmHg，2h后升至86.3±7.3mmHg、12h后升至81.9±3.9mmHg，24h后升至80.9±5.1mmHg。更多还原

【Abstract】 Purpose: The aim of this study was to find out the anatomic structure and variation of internal carotid artery of rabbit, and develop a new rabbit model with middle cerebral artery occlusion.Method: 20 rabbits were used to make the model of cerebral vessels, and 20 rabbits to make the model of middle cerebral artery occlusion by inserting fish line of 0.8 sizes into the origin of middle cerebral artery. After middle cerebral artery occlusion, cerebral temperature (CT), intracranial pressure (ICP), blood pressure (BP), cerebral perfusion pressure (CPP) and central venous pressure (CVP) were monitored. 48 hours later MRI scan were performed and then were killed, the brain tissues were stained by TTC.Result: There were two kinds of variation in internal carotid artery. Internal carotid artery is diverge from common carotid artery and walks for 4.2~4.8cm to reach the origin of middle cerebral artery without other branch in 85% rabbits. 15% internal carotid arteries have a branch, which supplies the ear before into cranium. After middle cerebral artery occlusion, the blood pressure and intracranial pressure rose up. The site and size were almost coincidence with MRI scan and TTC stain.Conclusion: The advantage of this rabbit model is small trauma and easily made.更多还原