日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
〒162-0801東京都新宿区山吹町358-5アカデミーセンター Japanese Society of Pediatric Cardiology and Cardiac Surgery Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Pediatric Cardiology and Cardiac Surgery 34(3): 128-134 (2018)
doi:10.9794/jspccs.34.128

ReviewReview

動脈管の収縮形態:ラット動脈管断面像天然色図譜Natural Color Cross-Sectional Morphology of Constricted Ductus Arteriosus in Rat

東京女子医科大学循環器小児科Department of Pediatric Cardiology, Tokyo Women’s Medical University ◇ Tokyo, Japan

発行日:2018年9月1日Published: September 1, 2018
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生体内動脈管の収縮を研究するため,ラット胎仔と新生仔を全身急速凍結法で固定し凍結ミクロトームで胸部を矢状面,前額面,横断面,または四腔断面で切り,0.5 mmごとに断面カラー写真を連続撮影した.胎仔の矢状面で胎生期主要血流路である右室漏斗部–主肺動脈–動脈管–下降大動脈が一断面に同じ太さで明示された.新生仔の矢状面で生後30分の動脈管の管状収縮が明示され,出生後90分で速やかに管状の狭窄を経て閉鎖した.動脈管索は生後3日で著明な短縮を生じた.胎生期動脈管の薬剤性収縮は新生仔の動脈管収縮と異なる形態を示した.即ちインドメサシンを親ラットに経口投与すると4時間後の中央部に強い砂時計型収縮,8~24時間後の限局性の大動脈側の膜状収縮が明示された.この特徴ある胎生期動脈管収縮は全て薬剤による収縮,即ちインドメサシンなど鎮痛解熱剤,ベタメサゾンなどステロイドホルモン,グリベンクラミドなどのスルホニル尿素薬によるラット胎仔動脈管収縮で観察された.胎仔動脈管収縮24時間持続後の四腔断面には右室の内腔狭小化と壁肥大,左室の拡張と肥大,心嚢液貯留が明示された.

In-situ cross-sectional morphology of the fetal and neonatal rat ductus arteriosus (DA) is studied by rapid whole-body freezing, cutting on a freezing microtome, and photographing the cross-section serially every 0.5 mm with a stereoscopic microscope (Wild M400). Thoracic sagittal sections reveal the right ventricular (RV) infundibulum, main pulmonary artery, DA, and descending aorta in one plane. This forms the major circulatory route in the fetus. Serial frontal and sagittal sections of the neonatal thorax reveal rapid tubular constriction at 1 hour and complete closure at 2 hours after birth. Fetal DA shows different patterns of pharmacological constriction. Fetal DA constriction by indomethacin is initially tubular at 1 and 2 hours after orogastric administration to the mother rat but becomes sandglass shaped and eventually becomes distal, short, tubular, or membranous at 8 and 24 hours after administration. These patterns of constriction are observed after pharmacological agents are administered transplacentally or directly to the fetus; this includes DA constriction after administration of cyclooxygenase inhibitors such as aspirin, indomethacin, and ibuprofen, constriction after administration of glucocorticoid hormones such as betamethasone, and constriction after administration of sulfonylureas such as glibenclamide and glimepiride. Persistent fetal DA constriction after administration of indomethacin for more than 24 hours induces RV concentric hypertrophy with diminished cavity and left ventricular dilatation with increased ventricular muscle mass in 4-chamber view sections.

Key words: fetus; ductus arteriosus; ductus constriction; ductus closure; indomethacin

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This page was last modified on 2018-09-11T14:52:54.354+09:00


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