定容積動物モデルと定圧動物モデルを用いた腹腔内高血圧症の比較試験を行った

[A comparative study of "constant volume" animal model and "constant pressure" animal model of intra-abdominal hypertension].

• Yong Chen
• Hongye Wang
• Xiufeng Yang
• Fenglong Qi
• Jinyu Qiao
• Panpan Zhang

抄録

目的:

複数の水嚢重畳圧迫法とガス灌流法の比較検討を通じて、腹部コンパートメント症候群（ACS）の病態生理とより整合性の高い動物モデルを選択すること。

OBJECTIVE: To select the animal model more consistent with the pathophysiology of abdominal compartment syndrome (ACS) through the comparative study of the methods of multiple water sacs superimposed compression and gas perfusion.

方法:

10頭の実験用ブタを無作為に2群（n=5）に分け、腹腔内高血圧の「定容積モデル」（定容積モデル群）と「定圧モデル」（定圧モデル群）を作成した。モデルは、それぞれ水嚢重畳加圧法、人工気腹膜法で作成した。両群の腹圧は25mmHg（1mmHg＝0.133kPa）とし、4時間観察した。4時間、1時間に1回圧力を測定し、両群の圧力-時間曲線をそれぞれ描いた。実験動物はモデル化の4時間後に犠牲にした。心臓と肺を摘出し、ヘマトキシリン-エオシン（HE）染色により病理組織学的変化を観察した。

METHODS: Ten experimental pigs were randomly divided into two groups (n = 5): the "constant volume model" (constant volume model group) and the "constant pressure model" (constant pressure model group) of intra-abdominal hypertension. The models were prepared by the method of water sac superposition and pressurization, and artificial pneumoperitoneum respectively. The abdominal pressures of both groups were 25 mmHg (1 mmHg = 0.133 kPa) and observed for 4 hours. The pressure was measured once an hour for 4 hours and the pressure-time curves of the two groups were drawn respectively. The experimental animals were sacrificed 4 hours after modeling. The heart and lung were harvested, and the histopathological changes were observed by hematoxylin-eosin (HE) staining.

結果:

2群の実験ブタのモデル化に成功した。定容積モデル群では、術後0,1,2,3,4時間で腹圧が徐々に上昇していた（mmHg.25.0±0、27.1±0.2、29.4±0.1、30.9±0.2、33.1±0.1）であり、腹圧と時間との間には正の相関があった（関数式：Y＝25.102 0+1.996 0X；R＝0.996 2、P＝0.000 1）。定圧モデル群の0,1,2,3,4時間の腹圧値は25mmHgを維持しており、腹圧と時間との間には直線的な相関は認められなかった（機能式：Y=25）。HE染色の結果、定容積モデル群では、心筋線維にヒアライン変性を伴い、横線が著しく減少し、心筋線維の一部が萎縮し、目に見える核凝集が認められた；肺組織に出血、慢性炎症性細胞浸潤、炎症性滲出物が認められた。定圧モデル群では、心筋線維の部分的萎縮、部分的肥大、局所的なヒアリン変性、局所筋の消失、心筋線維のヒアリン変性、心筋間動脈の拡張とうっ血が認められた。肺胞上皮のわずかな過形成が一部に認められ、心不全細胞、気管支・気管支動脈の拡張・うっ血、赤血球の多さ、内腔内の均一な光染色物質が認められた。

RESULTS: Two groups of experimental pigs were successfully modeled. The abdominal pressure gradually increased at 0, 1, 2, 3, 4 hours after operation in the constant volume model group (mmHg: 25.0±0, 27.1±0.2, 29.4±0.1, 30.9±0.2, 33.1±0.1), and there was a positive correlation between the abdominal pressure and time (functional equation: Y = 25.102 0+1.996 0X; R = 0.996 2, P = 0.000 1). The abdominal pressure value in the constant pressure model group at 0, 1, 2, 3, 4 hours were maintained 25 mmHg, and there was no linear correlation between the abdominal pressure and time (functional equation: Y = 25). HE staining showed that in the constant volume model group, the myocardial fibers were accompanied with hyaline degeneration, significantly reduced transverse lines, part of myocardial fiber atrophy, and visible nuclear aggregation; hemorrhage, chronic inflammatory cell infiltration and inflammatory exudation were found in the lung tissues. In the constant pressure model group, partial atrophy of myocardial fiber, partial hypertrophy, focal hyaline degeneration, disappearance of local striae, hyaline degeneration of myocardial fiber, dilation and congestion of intermyocardial artery were observed. Slight hyperplasia of alveolar epithelium in some areas, heart failure cells, dilation and congestion of bronchi and trachea artery, a large number of red blood cells and uniform light staining substances in lumen were found.

結論:

複数の水嚢を用いた方法でモデル化した後は、発症に伴って腹腔内の圧力が上昇し続け、ACSの臨床病理学的変化と一致しており、腹腔内高血圧症の動物モデル化にはより適していた。

CONCLUSIONS: After the model was made by the method of multiple water sacs, the pressure of the abdominal cavity continued to increase with the development of the disease, which was in line with the clinical pathological changes of ACS, and was more suitable for making the animal model of the intra-abdominal hypertension.