CAJ | 학술논문

目的:探讨在不同血液流速中,肝素包被对异种脱细胞血管移植物在移植术后的影响.方法:犬颈动脉经脱细胞处理后,分为A 组(未结合肝素)(n=9)和 B 组(结合肝素)(n=9),分别双侧移植到18只兔体内.移植后结扎左侧两吻合口间的颈动脉(结扎侧),而右侧不结扎(未结扎侧);术后1周、3周和12周对所有兔做超声检测,测量血管内径,计算血流动力学参数.结果:(1)A 组的移植物血管内径无论在结扎侧或未结扎侧均较术前明显缩小(P<0.05),且未结扎侧的管腔内径较结扎侧明显缩小(P<0.01);B 组中仅有未结扎侧第3、12周的内径较术前比较差异具有统计学意义(P<0.05).(2)A 组中的 PSV 随时间延长呈上升趋势,而 B 组中的 PSV 变化并不明显;术后第 3周时,两组阻力指数(RI)比较差异有统计学意义(P<0.05).结论:低流速对移植物血管的内膜增生具有促进作用;肝素包被可以有效地抑制内膜增生的发生;彩色多普勒超声检查为实验研究脱细胞血管移植物异体移植后的血流动力学变化提供了一种直观、无创、重复性好的方法.
목적:탐토재불동혈액류속중,간소포피대이충탈세포혈관이식물재이식술후적영향.방법:견경동맥경탈세포처리후,분위A 조(미결합간소)(n=9)화 B 조(결합간소)(n=9),분별쌍측이식도18지토체내.이식후결찰좌측량문합구간적경동맥(결찰측),이우측불결찰(미결찰측);술후1주、3주화12주대소유토주초성검측,측량혈관내경,계산혈류동역학삼수.결과:(1)A 조적이식물혈관내경무론재결찰측혹미결찰측균교술전명현축소(P<0.05),차미결찰측적관강내경교결찰측명현축소(P<0.01);B 조중부유미결찰측제3、12주적내경교술전비교차이구유통계학의의(P<0.05).(2)A 조중적 PSV 수시간연장정상승추세,이 B 조중적 PSV 변화병불명현;술후제 3주시,량조조력지수(RI)비교차이유통계학의의(P<0.05).결론:저류속대이식물혈관적내막증생구유촉진작용;간소포피가이유효지억제내막증생적발생;채색다보륵초성검사위실험연구탈세포혈관이식물이체이식후적혈류동역학변화제공료일충직관、무창、중복성호적방법.
Objective: Using duplex Doppler utrasound method to explore the effect of heparin coating on intimal hyperplasia in small-caliber decellularized xenografts after implantation into a different blood flow model. Method: Canine carotid arteries were decellularized by detergent and enzyme (A part of decellularized vascular grafts were covalently linked with heparin). Then bilateral carotid implantation were performed respectively in 18 rabbits. To establish a different blood flow model,left carotid between the anastomotic stoma was ligated while right carotid was not after implantation. All the rabbits were randomly divided into two groups: A group(non-heparin-linked)(n=9)and B group(heparin-linked)(n=9). Each animal was examined by ultrasound to evaluate the diameter of the implanted xenografts and calculate the parameter of the hemodynamics,such as PSV RI and PI, in postoperation 1,3 and 12 weeks respectively. Result:(1)Compared with preoperation,the luminal diameter was obviously narrowing in both ligated side and non-ligated side of A group(P<0.05). The luminal diameter of non-ligated side was narrowing than that of ligated side. While only the luminal diameter of non-ligated side in B group at 3 and 12 weeks was narrowing than the initials(P<0.05).(2)With time increased,the PSV in A group also increased while there was no obvious change in B group. The RI in 3 weeks was obviously different between the two groups(P<0.05). Conclusion: Lower blood flow can promote the intimal hyperplasia occur. Heparin coating can reduce it happen efficiently. The high resolution ultrasound provide a direct and nontraumatic method in researching the hemodynamic change in small-caliber decellularized xenograft.