CAJ | 학술논문

目的观察以猪血纤维蛋白/微孔聚氨酯弹性膜为管形支架内皮化构建的小口径血管移植物在体内血流动力条件下血管壁重塑过程.方法用体外培养的小口径血管移植物置换6条犬双侧颈总动脉,于术后1 d、1周、2周、4周行影像学检查,并于术后5 d、2周、4周取材行组织学、免疫组织化学和扫描电镜检查以评价移植血管在体内重塑.结果 10根血管移植物中有8根仍保持通畅(通畅率80%);8根通畅的血管在术后至4周的不同时点取出发现其内表面菲薄、光滑,被覆盖一连续、鹅卵石样单层细胞,Ⅷ因子相关抗原抗体染色阳性.术后4周时新生动脉壁厚900μm,并于血管壁中层可见较多平滑肌细胞,而且最早于术后4周时在血管壁中层就可见弹力纤维.结论猪血纤维蛋白/微孔聚氨酯弹性膜管形支架内皮化体外构建的小口径血管移植物在体内重塑后,可形成具有类似自体动脉壁结构.
목적 관찰이저혈섬유단백/미공취안지탄성막위관형지가내피화구건적소구경혈관이식물재체내혈류동력조건하혈관벽중소과정.방법 용체외배양적소구경혈관이식물치환6조견쌍측경총동맥,우술후1 d、1주、2주、4주행영상학검사,병우술후5 d、2주、4주취재행조직학、면역조직화학화소묘전경검사이평개이식혈관재체내중소.결과 10근혈관이식물중유8근잉보지통창(통창솔80%);8근통창적혈관재술후지4주적불동시점취출발현기내표면비박、광활,피복개일련속、아란석양단층세포,Ⅷ인자상관항원항체염색양성.술후4주시신생동맥벽후900μm,병우혈관벽중층가견교다평활기세포,이차최조우술후4주시재혈관벽중층취가견탄력섬유.결론 저혈섬유단백/미공취안지탄성막관형지가내피화체외구건적소구경혈관이식물재체내중소후,가형성구유유사자체동맥벽결구.
Objective To investigate the in vivo morphological change of hybrid vascular graft made of porcine fibrin and microprocessed SPU film under the hemodynamic condition for predetermined period of time. Methods Autologous vascular endothelial cells derived from the saphenous veins of 6 adult mongrel dogs were cultured and proliferated in vitro in M199 culture medium, prelined on the luminal surface of lyophilized porcine fibrin tube wrapped with a SPU thin film with multiple micropores as a compliant scaffold. After canine common carotid arteries were bilaterally replaced with these vascular grafts for 4 weeks, light and electron microscopy, radiological imaging examination and immunohistochemistry were performed to evaluate the patency and remodeling in vivo. Results Eight of 10 engineered vascular grafts were patent ( patency rate 80% ). The patent grafts possessed thin, smooth and glistening luminal surfaces at the predetermined observation period up to 4 weeks. The intimal layer was covered with confluent, cobblestone-like monolayered cells that were positively stained with factor Ⅷ-related antigen. The thickness of the neoarterial walls was about 900 μm at 4th week after implantation. Vascular medial tissue rich in smooth muscle cells in the hierarchic structures of arterial wall was observed, and more interestingly, mass of elastic fiber was found in the medial tissue as early as 4 weeks postoperatively. Conclusion The endothelialized hybrid vascular grafts can be transformed to similar hierarchic structures of arterial walls under the hemodynamic condition for as early as 4 weeks.