摘要
目的探讨肝素包被对异种脱细胞血管移植后内膜增生的影响。方法将截取的犬双侧颈动脉进行脱细胞处理,对其中部分颈动脉进一步实施肝素包被处理。18只新西兰大白兔随机分为肝素包被组(移植经肝素包被处理的脱细胞血管,n=9)和无肝素包被组(移植未经肝素包被处理的脱细胞血管,n=9)。两组动物均接受双侧颈动脉移植,血管吻合后结扎左侧两吻合口间颈动脉(结扎侧),右侧则不结扎(未结扎侧)。于术后第1、3、12周分别进行血管多普勒超声检查,观察移植血管通畅情况并测量血管内径,同时计算血流峰值速度(PSV)、阻力指数(RI)和搏动指数(PI)等血流动力学参数。术后12周末处死所有动物,取双侧移植物血管,制备标本观察组织形态学改变,计算内膜厚度/(内膜厚度十中膜厚度)[I/(I+M)],同时进行统计学分析。结果无肝素包被组术后血管内径,除结扎侧术后第1周外均较术前明显缩小;各时间点未结扎侧均较结扎侧明显缩小;以上差异均有统计学意义(P<0.05)。肝素包被组术后血管内径,仅未结扎侧于术后第3、12周时较术前明显缩小,差异有统计学意义(P<0.05)。术后第3周,肝素包被组RI明显小于未肝素包被组,组间比较差异有统计学意义(P<0.05)。无肝素包被组未结扎侧内膜增生明显,I/(I+M)值较结扎侧明显增大,差异有统计学意义(P<0.001);肝素包被组结扎侧与未结扎侧I/(I+M)比较差异无统计学意义。结论脱细胞血管移植物在不同剪切力作用下内膜增生情况也不相同,低流速对移植物血管内膜增生具有促进作用;肝素包被处理可有效抑制内膜增生的发生。
Objective To investigate the effects of heparin coating on intimal hyperplasia in implanted decellularized xenografts. Methods The resected canie carotid arteries were decellularized, and heparin coating was partially performed. Eighteen rabbits were divided into non-heparin-coated group （ n = 9） and heparin-coated group （ n = 9）. During implantation, only the left carotid between the anastomotic stoma was ligated. Doppler uhrasonography was performed 1, 3 and 12 weeks post-implantation to measure the luminal diameter, and the hemodynamic parameters such as PSV, RI and PI were calculated. All animals were sacrificed, histological observations were conducted at 12 weeks post-implantation, and I/（ I ＋ M） was calculated. Results Except for 1 week post-implantation in the ligated side, the luminal diameters in non- heparin-coated group were significantly smaller than that of pre-implantation. Besides, those of the non-ligated side at each time points were significantly smaller than the ligated side （P 〈 0.05）. However, only those of the non-ligated side 3 and 12 weeks post-implantation were significantly smaller than that of pre-implantation in heparin-coated group （P 〈 0.05）. RI was significantly smaller in heparin-coated group than in non-heparin-coated group 3 weeks post-implantation （ P 〈 0.05 ）. The intima thickness was significantly increased in the non-liaged side in non-heparin-coated group, and I/（ I ＋ M） was significantly higher than the ligated side （P 〈 0. 001 ）. There was no significant difference in I/（ I ＋ M） between the ligated side and non-ligated side in heparin-coated group. Conclusion There are different conditions of intimal hyperplasia in decellularized xenografts under different shear force of blood flow, and lower blood flow velocity promotes intimal hyperplasia. Heparin coating can effectively reduce intimal hyperplasia.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2008年第11期1420-1424,共5页
Journal of Shanghai Jiao tong University:Medical Science
关键词
肝素
脱细胞血管
小口径血管
内膜增生
多普勒超声
heparin
decellularized vessel
small-caliber vessel
intimal hyperplasia
doppler ultrasound
