中国组织工程研究与临床康复
中國組織工程研究與臨床康複
중국조직공정연구여림상강복
JOURNAL OF CLINICAL REHABILITATIVE TISSUE ENGINEERING RESEARCH
2007年
50期
10209-10212
,共4页
王毅%陈易人%戴坤扬%钮宏文%伍波%李里%戚大川
王毅%陳易人%戴坤颺%鈕宏文%伍波%李裏%慼大川
왕의%진역인%대곤양%뉴굉문%오파%리리%척대천
内皮细胞%人工血管%内皮化%移植
內皮細胞%人工血管%內皮化%移植
내피세포%인공혈관%내피화%이식
背景:已有实验表明,通过自体血管内皮细胞种植于人工血管腔面提高了血管移植的通畅率.骨髓内皮细胞衬里人工血管是否有利于人工血管体内的内皮化过程?目的:通过骨髓内皮细胞衬里人工血管间置移植的动物实验观察人工血管内皮化效果.设计:观察对比动物实验.单位:上海市第六人民医院.材料:实验于2000-09/2001-10在上海市第六人民医院完成.选用20只上海地区杂种犬,犬龄1.0～2.0岁,雌雄不拘,体质量(18.7±2.3)kg.方法:分离犬骨髓单核细胞,ePTFE人工血管以2种规格(4 mm×4 cm和8 mm×5 cm)完成内皮化.颈总动脉移植:选用10只实验犬切除颈总动脉主干4 cm,将直径4 mm长4 cm的ePTFE人工血管间置移植于双侧颈总动脉,内皮化人工血管为实验组,未经内皮化人工血管为对照组,每组5只.术后2周及2个月采用彩色超声检查移植血管通畅率及血流速率.下腔静脉移植:选用剩余10只实验犬,6只为实验组,实验犬麻醉下将下腔静脉游离约8～10 cm,阻断两端,切除约5 cm,取直径8 mm长5 cm内皮化ePTFE人工血管,以5-0 Prolene作端端吻合,4只为对照组,以相同规格ePTFE人工血管为移植血管.术后2个月测定血管通畅率.同时与上述时间点计算各组移植血管内皮细胞覆盖率及内膜厚度.主要观察指标:①各组实验犬不同时间点移植血管通畅率及血流速率.②各组移植血管内皮细胞覆盖率及内膜厚度.结果:①颈总动脉移植术后2周和2月实验侧通畅率分别为100%(5/5)和60%(3/5),同期对照侧通畅率分别为40%(2/5)和0%(0/5).术后2个月实验组平均血流速率明显小于对照组(P＜0.05).下腔静脉移植实验组和对照组2月移植血管通畅率为83%(5/6)和50%(2/4).②颈总动脉及下腔静脉移植术后2周实验组血管腔面内皮细胞覆盖率大于对照组,差异有显著性意义(P＜0.05),术后2个月实验组血管内膜厚度小于对照组,差异有显著性意义(P＜0.05).结论:骨髓内皮细胞衬里的ePTFE人工血管在体内能较快完成内皮化过程,能抑制内膜增生;循环内皮细胞作为内皮细胞的潜在来源,具有一定临床应用价值.
揹景:已有實驗錶明,通過自體血管內皮細胞種植于人工血管腔麵提高瞭血管移植的通暢率.骨髓內皮細胞襯裏人工血管是否有利于人工血管體內的內皮化過程?目的:通過骨髓內皮細胞襯裏人工血管間置移植的動物實驗觀察人工血管內皮化效果.設計:觀察對比動物實驗.單位:上海市第六人民醫院.材料:實驗于2000-09/2001-10在上海市第六人民醫院完成.選用20隻上海地區雜種犬,犬齡1.0～2.0歲,雌雄不拘,體質量(18.7±2.3)kg.方法:分離犬骨髓單覈細胞,ePTFE人工血管以2種規格(4 mm×4 cm和8 mm×5 cm)完成內皮化.頸總動脈移植:選用10隻實驗犬切除頸總動脈主榦4 cm,將直徑4 mm長4 cm的ePTFE人工血管間置移植于雙側頸總動脈,內皮化人工血管為實驗組,未經內皮化人工血管為對照組,每組5隻.術後2週及2箇月採用綵色超聲檢查移植血管通暢率及血流速率.下腔靜脈移植:選用剩餘10隻實驗犬,6隻為實驗組,實驗犬痳醉下將下腔靜脈遊離約8～10 cm,阻斷兩耑,切除約5 cm,取直徑8 mm長5 cm內皮化ePTFE人工血管,以5-0 Prolene作耑耑吻閤,4隻為對照組,以相同規格ePTFE人工血管為移植血管.術後2箇月測定血管通暢率.同時與上述時間點計算各組移植血管內皮細胞覆蓋率及內膜厚度.主要觀察指標:①各組實驗犬不同時間點移植血管通暢率及血流速率.②各組移植血管內皮細胞覆蓋率及內膜厚度.結果:①頸總動脈移植術後2週和2月實驗側通暢率分彆為100%(5/5)和60%(3/5),同期對照側通暢率分彆為40%(2/5)和0%(0/5).術後2箇月實驗組平均血流速率明顯小于對照組(P＜0.05).下腔靜脈移植實驗組和對照組2月移植血管通暢率為83%(5/6)和50%(2/4).②頸總動脈及下腔靜脈移植術後2週實驗組血管腔麵內皮細胞覆蓋率大于對照組,差異有顯著性意義(P＜0.05),術後2箇月實驗組血管內膜厚度小于對照組,差異有顯著性意義(P＜0.05).結論:骨髓內皮細胞襯裏的ePTFE人工血管在體內能較快完成內皮化過程,能抑製內膜增生;循環內皮細胞作為內皮細胞的潛在來源,具有一定臨床應用價值.
배경:이유실험표명,통과자체혈관내피세포충식우인공혈관강면제고료혈관이식적통창솔.골수내피세포츤리인공혈관시부유리우인공혈관체내적내피화과정?목적:통과골수내피세포츤리인공혈관간치이식적동물실험관찰인공혈관내피화효과.설계:관찰대비동물실험.단위:상해시제륙인민의원.재료:실험우2000-09/2001-10재상해시제륙인민의원완성.선용20지상해지구잡충견,견령1.0～2.0세,자웅불구,체질량(18.7±2.3)kg.방법:분리견골수단핵세포,ePTFE인공혈관이2충규격(4 mm×4 cm화8 mm×5 cm)완성내피화.경총동맥이식:선용10지실험견절제경총동맥주간4 cm,장직경4 mm장4 cm적ePTFE인공혈관간치이식우쌍측경총동맥,내피화인공혈관위실험조,미경내피화인공혈관위대조조,매조5지.술후2주급2개월채용채색초성검사이식혈관통창솔급혈류속솔.하강정맥이식:선용잉여10지실험견,6지위실험조,실험견마취하장하강정맥유리약8～10 cm,조단량단,절제약5 cm,취직경8 mm장5 cm내피화ePTFE인공혈관,이5-0 Prolene작단단문합,4지위대조조,이상동규격ePTFE인공혈관위이식혈관.술후2개월측정혈관통창솔.동시여상술시간점계산각조이식혈관내피세포복개솔급내막후도.주요관찰지표:①각조실험견불동시간점이식혈관통창솔급혈류속솔.②각조이식혈관내피세포복개솔급내막후도.결과:①경총동맥이식술후2주화2월실험측통창솔분별위100%(5/5)화60%(3/5),동기대조측통창솔분별위40%(2/5)화0%(0/5).술후2개월실험조평균혈류속솔명현소우대조조(P＜0.05).하강정맥이식실험조화대조조2월이식혈관통창솔위83%(5/6)화50%(2/4).②경총동맥급하강정맥이식술후2주실험조혈관강면내피세포복개솔대우대조조,차이유현저성의의(P＜0.05),술후2개월실험조혈관내막후도소우대조조,차이유현저성의의(P＜0.05).결론:골수내피세포츤리적ePTFE인공혈관재체내능교쾌완성내피화과정,능억제내막증생;순배내피세포작위내피세포적잠재래원,구유일정림상응용개치.
BACKGROUND: Experiments have demonstrated that autologous vascular endothelial cells if transplanted onto artificial vascular cavosurface, can enhance the patency rate of vasotransplantation. Whether seeding of prostheses interposition grafts with bone marrow-derived endothelial cells is effective for in vivo endothelialization of artificial vessels remains unclear.OBJECTIVE: To observe the effect of endothelialization of vascular prosthesis by seeding prostheses interposition grafts with bone marrow-derived endothelial cells in animals.DESIGN: A controlled animal experimental study.SETTING: Shanghai Sixth People's Hospital.MATERIALS: This study was carried out in the Shanghai Sixth People's Hospital between September 2000 and October 2001. Twenty hybrid dogs from Shanghai, of either gender, aged 1.0 to 2.0 years old, weighing (18.7±2.3) kg, were involved in this study.METHODS: Bone marrow-derived mononuclear cells were isolated from the dogs. The endothelialization of ePTFE prostheses interposition grafts (4 mm×4 cm and 8 mm×5 cm)was carried out. Common carotid artery transplantation:Ten laboratory dogs were involved. Common carotid artery of 4 cm was resected from each dog. ePTFE prostheses interposition grafts of 4 mm×4 cm was transplanted into the bilateral common carotid artery, and prostheses interposition grafts were performed endothelialization, namely experimental group. Those prostheses interposition grafts, which were not performed endothelialization, were named as control group. Five dogs were used in each group. Patency rate and blood flow rate of transplanted vessels were detected with a color ultrasonograph 2 weeks and 2 months after operation.Inferior caval vein transplantation: Six of the rest 10 dogs were used for experiments. Under the anesthesia, 8-10 cm inferior caval vein was dissociated from each dog. Its two ends were blocked, and about 5 cm inferior caval vein was resected. ePTFE endothelialized vascular prosthesis with 8 mm in diameter and 5 cm in length was anastomosed end to end with 5-0 Prolene. The other 4 dogs were used for control experiment. ePTFE vascular prosthesis with the same specification was used as prostheses interposition graft. Vascular patency rate was determined 2 months after operation.At the same time, coverage rate and intimal thickness of transplanted vascular endothelial cells and vascular intimal thickness were determined.MAIN OUTCOME MEASURES: ①The patency rate and blood flow rate of transplanted vessels at different time points. ②Coverage rate of transplanted vascular endothelial cells and vascular intimal thickness.RESULTS:① At 2 weeks and 2 months after common carotid artery transplantation, the patency rate of experimentalside was 100%(5/5)and 60%(3/5), respectively, and that of control side was 40%(2/5)and 0%(0/5), respectively. At postoperative 2 months, the mean blood flow rate in the experimental group was obviously smaller than that in the control group (P ＜ 0.05). At 2 months after inferior caval vein transplantation, the patency rate of experimental group and control group was 83%(5/6)and 50%(2/4), respectively. ②At 2 weeks after common carotid artery transplantation and inferior caval vein transplantation, the coverage rate of vascular endothelial cells in the experimental group was significantly larger than that in the control group, separately (P ＜ 0.05). At 2 months after each transplantation, the vascular intimal thickness in the experimental group was significantly smaller than that in the control group (P ＜ 0.05).CONCLUSION: Seeding of ePTFE prostheses interposition grafts with bone marrow-derived endothelial cells can rapidly accomplish in vivo endothelialization and inhibit intimal hyperplasy; Circulating endothelial cells, as the potential source of endothelial cells, have certain clinical application values.
