摘要
目的探讨构建的组织纤溶酶原激活物(tissueplaminogenactivator,t-PA)基因质粒对预防机械瓣膜置换术后血栓形成的作用。方法人工构建t-PA基因表达质粒,用阳离子质脂体包裹并制备成基因缝线。选择18只猪随机分为实验组和对照组,每组9只,行三尖瓣膜置换术的同时将基因缝线缝合于心肌组织,以超声波辅助转导心脏细胞产生高活性t-PA,观察术后瓣膜血栓形成、凝血功能和纤溶降解产物D-二聚体含量以及动物生存状况。结果成功构建了t-PA基因质粒并获得在心脏中表达。在对照组,于术后第1周血D-二聚体含量达高峰,平均(1.7±0.8)mg/L,于第2周明显下降接近术前;实验组于术后1周明显增高达(1.8±0.8)mg/L,与对照组差异无统计学意义(P>0.05);此后观察各期仍维持较高状态,术后2,4,8和12周检测值分别为(1.3±0.5)mg/L、(1.2±1.0)mg/L、(1.8±1.2)mg/L和(1.9±0.8)mg/L,比对照组均显著增高(P<0.01)。对照组瓣口和瓣周血栓形成率9/9,而实验组仅1/9(P<0.01)。结论构建的t-PA基因质粒可预防机械瓣膜置换术后血栓形成。
Objectives To study on a constructed tissue plaminogen activator （t-PA） to prevent the thrombosis after mechanical valve replacement. Methods A t-PA gene plasmid was constructed and packaged with a novel cationic phosphonolipid and a t-PA gene thread was made. 18 pigs were selected and subgrouped into two groups： 9 in experimental and 9 in control group for the mechanical tricuspid valve replacement. In experimental group, the gene threads were sutured into the wall of heart with the ultrasound treatment for the gene transfection at the same time of operation. The thrombosis on the valves, coagulative function and D-dimer level of the blood were observed. Results t-PA gene plasmid was successfully constructed and t-PA protein was expressed in the heart. D-dimer reached its peak level of （1.7±0.8）mg/L one week after operation, with no difference when compared with the experimental group, and decreased thereafter in the control group. In experimental group, D-dimer increased 1 week after operation with the content of （1.8±0.8）mg/L and kept its high level in the observed period with the contents of （1.3±0.5）mg/L, （1.2±1.0）mg/L,（1.8±1.2）mg/L and （1.9±0.8）mg/L 2,4,8 and 12 week after operation,respectively. There were thrombosis around the valves in all conuol group pigs（9/9）and only one had thrombosis in experimental group （1/9）. Conclusions The construted tPA gene plasmid could be used for the prevention of thrombosis after mechanical valve replacement.
出处
《岭南心血管病杂志》
2006年第2期132-135,共4页
South China Journal of Cardiovascular Diseases
基金
深圳市科技计划项目200104048
