CAJ | 학술논문

目的对优化设计FW-Ⅱ轴流泵短期辅助的抗血栓性能进行评价,为后期临床应用提供依据.方法 5只60～70 kg成年小尾寒羊,建立心室-泵-降主动脉旁路循环模型.FW-Ⅱ轴流泵辅助循环2周,分别在术前和置入泵术后1、2、3、7、10、14天抽取静脉血,应用流式细胞仪检测Annexin V,CD41/61及CD14量化外周血中活化血小板及白细胞-血小板聚集;检测不同转速下血小板活化及白细胞-血小板聚集体.实验结束后观察轴流泵各组成部分有无血栓形成,取材观察心、脑、脾、肾大体和镜下病理表现.结果同术前相比较,置入轴流泵术后实验动物血小板活化及白细胞-血小板聚集体形成显著增加,第2天达到高峰,7天内维持较高水平,后逐渐降低,但术后14天仍高于术前水平.泵转速8000转/min时活化血小板和白细胞-血小板聚集体数最低.实验结束后拆分泵,轴流泵轴根部有少量血栓形成,叶轮、泵管及前、后导叶无血栓形成,心、脑、脾、肾等主要脏器大体和镜下观察均无血栓形成及缺血梗死表现.结论 FW-Ⅱ型泵抗血栓性能良好,可用于短期循环辅助.特定转速下血小板活化和白细胞-血小板聚集体值达到最低.
목적 대우화설계FW-Ⅱ축류빙단기보조적항혈전성능진행평개,위후기림상응용제공의거.방법 5지60～70 kg성년소미한양,건립심실-빙-강주동맥방로순배모형.FW-Ⅱ축류빙보조순배2주,분별재술전화치입빙술후1、2、3、7、10、14천추취정맥혈,응용류식세포의검측Annexin V,CD41/61급CD14양화외주혈중활화혈소판급백세포-혈소판취집;검측불동전속하혈소판활화급백세포-혈소판취집체.실험결속후관찰축류빙각조성부분유무혈전형성,취재관찰심、뇌、비、신대체화경하병리표현.결과 동술전상비교,치입축류빙술후실험동물혈소판활화급백세포-혈소판취집체형성현저증가,제2천체도고봉,7천내유지교고수평,후축점강저,단술후14천잉고우술전수평.빙전속8000전/min시활화혈소판화백세포-혈소판취집체수최저.실험결속후탁분빙,축류빙축근부유소량혈전형성,협륜、빙관급전、후도협무혈전형성,심、뇌、비、신등주요장기대체화경하관찰균무혈전형성급결혈경사표현.결론 FW-Ⅱ형빙항혈전성능량호,가용우단기순배보조.특정전속하혈소판활화화백세포-혈소판취집체치체도최저.
Objective To evaluate in vivo antithrombosis property of optimized FW-Ⅱ axial blood pump and provides evidence for future clinical use.Methods A left ventricle-pump-descending aorta bypass model was established in five healthy sheep (60-70 kg) and the circulation of these sheep was assisted by FW-Ⅱ axial blood pump for 2 weeks.In preoperative and postoperative day 1,2,3,7,10 and 14,blood was drawn from the jugular vein to examine platelet activation and leukocyte-platelet aggregation respectively quantified with Annexin V,CD41/61 and CD14-PE by flow cytometry assays.Immediately after termination of the experiment,FW-Ⅱ axial blood pumps were explanted and each part was inspected for thrombus formation.Macroscopic and histological examinations were checked on heart,brain,kidney and spleen,respectively for thrombosis.Results Compared with preoperative baseline,the number of platelet activation and leukocyte-platelet aggregation reached a peak at postoperative day 2,it retained a high level within 7 days,then gradually decreased,but was still higher than preoperative level at dayl4.According to rotating speed,the number of platelet activation and platelet-leukocyte aggregation were lowest at the speed of 8000 r/min Minus thrombus were found in the front and rear hub of the pump rotor,and there was no thrombus at other components (flow straighter,impeller and pump housing).There were no ischemia and infarction evidences in macroscopic and histological examination of the heart,brain,kidney and spleen.Conclusion FW-II axial blood pump can be used to assist left ventricular circulation for 2 weeks with a satisfactory antithrombosis property.The level of platelet activation and leukocyte-platelet aggregation can be reduced to a lowest level at an optimized pump rotating speed.