多聚环氧化合物预处理同种异体静脉重建犬股动脉的实验研究  

Experiment research on restoration of canine femoral arteries with allogenic veins pretreated by polyepoxy compound

作　　者：梅劲桦[1] 田路[1] 张纪蔚[1] 

机构地区：[1]上海第二医科大学附属仁济医院,上海200001

出　　处：《全科医学临床与教育》2004年第3期167-170,共4页Clinical Education of General Practice

摘　　要：目的探索新型交联材料多聚环氧化合物(PolyepoxyCompound,PC)预处理同种异体静脉的实验应用。方法将多聚环氧化合物、戊二醛(Glutaraldehyde,GA)交联后的同种异体犬脉以及自体犬静脉(Fresh)进行30只杂种犬双侧股动脉移植 ,在术后3d、7d、14d、30d、60d、90d各个时间点以多普勒超声检测或DSA造影观测血管通畅情况 ,并取血管进行射电镜观察。结果①在移植后的早期(<14d内) ,PC组、GA组和Fresh组累积通畅率分别为64.20%、42.86%和90.00%。但从移植后30d起 ,GA组累积通畅率急剧下降到6.12% ,而PC组在术后30d、60d和90d的累积通畅率分别为48.15%、21.88 %和13.13% ,在各个观察时间期都较GA组高 ,两组之间累积通畅率曲线的分布有统计学的差异(P<0.05)。Fresh组各时间段的累积通畅率也较GA组高 ,两组之间有统计学上的显著差异(P<0.01)。而PC组和Fresh组累积通畅率曲线的分布无统计学差异(P>0.05) ;②PC组在7d时可见内皮细胞从受体动脉向静脉爬行 ,90d时新生内皮细胞已覆盖静脉表面。GA组14d吻合口处内皮细胞开始爬行 ,但爬行距离较PC组短 ,90d可见内膜面有局灶状分布的新生内皮细胞。Fresh组7d内膜面见残存的内皮细胞 ,30d内皮细胞已重新覆盖内膜面。结论PC处理静脉毒性小于GA处理静脉 ,更有利于内皮细胞生长。Objective To evaluate the efficacy of a novel crosslinking reagent,polyepoxy compound,and hope to find a convenient method to pretreat the allogenic vessels and provide sufficient grafts for clinical practice.Methods Thirty mongrel canines were undergone bilateral femoral arteries transplantation with homogenic veins or allogenic veins pretreated by PC or GA.ON the3 rd ,7 th ,14 th ,30 th ,60 th ,90 th day after operation,the patency of the grafts was evaluated by Doppler Ultrasonic or DSA.Segments of graft vessels were observed by SEMand TEM.Results①Within fourteen days after the transplantation,the accumulative patency of PC group,GA group and Fresh group was64.20%,42.86%and90.00%respectively.But after the30 th day post-transplantation,the accumulative patency of GA group reduced to6.12%.On the contrary,the accumulative patency of PC group on the30 th ,60 th ,90 th day were48.15%,21.88%and13.13%respectively.These two groups had significant differences(P<0.05).The accumulative patency of Fresh group was significant higher than GA group(P<0.01).But there were no significant differences between the PC group and the Fresh group(P>0.05).②In the PC group,on the7 th day after trans-plantation,endothelia cells began to migrate from host artery to graft vein.On the90 th day,the graft vein was covered with new endothelia cells.In the GA group,endothelia cells began to migrate on the14 th day,and only part of the graft vein was covered with endothelia cells on the90 th day.In the Fresh group,endothelia cells residue could be observed on the7 th day,and on the30 th day,the graft was covered with endothelia cells.Conclusion The toxicity of veins pretreated by PC is lower than that of the veins pretreated by GA,so the grafts are propitious to the migration of endothelia cells.The new endothelia cells distribute more widely and densely in the PC group than in the GA group.

关 键 词：静脉 通畅率 内皮细胞 内膜 同种异体 股动脉 移植后 显著差异 情况 目的 

分 类 号：R654.4[医药卫生—外科学]