CAJ | 학술논문

目的观察自体窦房结细胞移植与电子起搏器"串联"起搏心脏的作用.方法健康成年犬12条,随机分为实验组和对照组(n=6).所有犬安置电子心脏起搏器以保证存活,然后切取窦房结.将实验组犬窦房结组织消化成细胞悬液后,注射到自体右室前壁心肌内,对照组相同部位注射等量培养液.2周后射频消融希氏束,建立完全性房室传导阻滞犬模型,观察并记录犬心律.对实验组犬经股静脉应用异丙肾上腺素,研究心律变化.免疫荧光染色观察移植的细胞存活状况及其与心室肌细胞形成的缝隙连接结构.结果建立完全性房室传导阻滞犬模型1 h后,实验组心率高于对照组(P＜0.01).注射异丙肾上腺素后,实验组心率变化明显(P＜0.01).实验组心律在14 d内保持稳定.免疫荧光染色法证实,移植的细胞在移植部位存活,且细胞间有缝隙连接结构形成.结论自体窦房结细胞移植是一种对儿茶酚胺类物质的调节作用反应敏感的生物起搏技术,并且在与电子起搏技术串联后,其起搏作用在14 d内保持稳定.移植的窦房结细胞可与周围细胞形成电-机械耦联的结构基础.
목적 관찰자체두방결세포이식여전자기박기"천련"기박심장적작용.방법 건강성년견12조,수궤분위실험조화대조조(n=6).소유견안치전자심장기박기이보증존활,연후절취두방결.장실험조견두방결조직소화성세포현액후,주사도자체우실전벽심기내,대조조상동부위주사등량배양액.2주후사빈소융희씨속,건립완전성방실전도조체견모형,관찰병기록견심률.대실험조견경고정맥응용이병신상선소,연구심률변화.면역형광염색관찰이식적세포존활상황급기여심실기세포형성적봉극련접결구.결과 건립완전성방실전도조체견모형1 h후,실험조심솔고우대조조(P＜0.01).주사이병신상선소후,실험조심솔변화명현(P＜0.01).실험조심률재14 d내보지은정.면역형광염색법증실,이식적세포재이식부위존활,차세포간유봉극련접결구형성.결론 자체두방결세포이식시일충대인다분알류물질적조절작용반응민감적생물기박기술,병차재여전자기박기술천련후,기기박작용재14 d내보지은정.이식적두방결세포가여주위세포형성전-궤계우련적결구기출.
Objective To explore the effect of autograft of sino-atrial nodal cells for pacing heart working with electronic pacemaker.Methods Twelve healthy adult dogs were randomly assigned to experimental group or control group.The sino-atrial node(SAN)Was harvested after the electronic pacemaker was implanted into the dogs.The SAN from dogs in experimental group was digested into cell suspension,then injected into autogenic right ventricular anterior wall.Commensurable culture medium Was injected into the same position in control group.Two week later,all dogs underwent electrophysiologic study and transeatheter ablation of His bundle to create three-degree AV block models.Isopmterenol(ISO)was administrated to the dogs in experimental group to investigate the change of the rhythm.Immunofluorescent staining Was done to investigate the survival of grafted cells and gap junction formed between cells.Results One h after the establishment of three-degree AV block models,heart rates in the dogs from experimental group were quicker than those in control group(P＜0.01).This escape rhythm Was altered remarkably when ISO was administrated(P＜0.01).And this rhythm maintained for 14 days.Immunofluoreacent staining suggested that the grafted SAN cells survived in ventficular myocardium and gap junctions expressed betwoen cells.Conclusion Autograft of SAN cells from adult dogs is a kind of biopacing techniques sensirive to ISO.This effect is stable during 14 days.Grafted SAN cells carl form gap junctions with adjacent myocytes.