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改良阿霉素大鼠模型中的食管闭锁及其他内脏异常及其与羊水量变化的相关性

Esophageal atresia and other visceral anomalies in a modified Adriamycin rat model and their correlations with amniotic fluid volume variations.

作者信息

França Willy M G, Gonçalves Anderson, Moraes Suzana G, Pereira Luis A V, Sbragia Lourenço

机构信息

Pediatric Surgery Division/Department of Surgery of the Medical Science Faculty, Universidade Estadual de Campinas-UNICAMP, R. da Pavuna, 20 Souzas Campinas, São Paulo, Brazil.

出版信息

Pediatr Surg Int. 2004 Aug;20(8):602-8. doi: 10.1007/s00383-004-1240-5. Epub 2004 Aug 26.

Abstract

The Adriamycin rat model (ARM) has been used to produce visceral malformations in fetuses to explain the mechanisms of foregut division. The models vary in the dosage of Adriamycin (ADR) and in the number of applications. Our study of a modified ARM using 2.2 mg/kg of ADR for 2 days only, intraperitoneally in pregnant rats, is presented. A total of 81 fetuses were obtained with this model from the ADR group, 74 (91%) alive. Uretero-hydronephrosis (UHN) was observed in 70 fetuses (95%), esophageal atresia (EA) in 68 (92%), duodenal atresia (DA) in 68 (92%), bladder hypoplasia (BH) in 67 (90%), plus other malformations. In evaluating amniotic fluid (AF) volume of the fetuses with EA with tracheo-esophageal fistula (TEF) (group I) and EA without TEF (group II), both associated with bilateral UHN when compared with the control group (group III), groups I and II showed higher AF volume in groups I and II than the control group (group III) did ( p=0.0001). In conclusion, ARM was adequate to produce EA and other visceral malformations. The use of ADR in a higher dosage for a shorter period of time produced better results than those presented in previous literature. The increase of AF volume obtained in fetuses presenting EA plus bilateral UHN strongly suggests, despite ureteral dilatation (urinary obstruction), that a malformed communication may exist between the urinary system and the amniotic cavity, permitting the existence of polyhydramnios that is due to digestive obstruction such as EA and DA.

摘要

阿霉素大鼠模型(ARM)已被用于在胎儿中产生内脏畸形,以解释前肠分隔的机制。这些模型在阿霉素(ADR)的剂量和应用次数上有所不同。本文介绍了我们对改良ARM模型的研究,该模型仅在怀孕大鼠腹腔内注射2.2mg/kg的ADR,持续2天。通过该模型,ADR组共获得81只胎儿,其中74只(91%)存活。观察到70只胎儿(95%)出现输尿管积水性肾盂积水(UHN),68只(92%)出现食管闭锁(EA),68只(92%)出现十二指肠闭锁(DA),67只(90%)出现膀胱发育不全(BH),以及其他畸形。在评估伴有气管食管瘘(TEF)的EA胎儿(I组)和不伴有TEF的EA胎儿(II组)的羊水(AF)量时,与对照组(III组)相比,I组和II组均伴有双侧UHN,I组和II组的AF量均高于对照组(III组)(p = 0.0001)。总之,ARM足以产生EA和其他内脏畸形。在较短时间内使用较高剂量的ADR比以前文献报道的结果更好。伴有EA加双侧UHN的胎儿AF量增加强烈表明,尽管存在输尿管扩张(尿路梗阻),但泌尿系统与羊膜腔之间可能存在畸形连通,从而导致因EA和DA等消化梗阻引起的羊水过多。

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