改性后的牛颈静脉带瓣管道在家犬中的实验研究  

Treated bovine jugular vein conduit as a ventricular outflow tract in dogs

作　　者：张竞超[1] 徐敬[1] 赵文增 吴忠仕[2] 胡建国[2] 

机构地区：[1]郑州大学第一附属医院心外科,450052 [2]中南大学湘雅二医院心外科

出　　处：《中华小儿外科杂志》2007年第3期152-156,共5页Chinese Journal of Pediatric Surgery

基　　金：河南省自然科学基金资助（编号：511051100）

摘　　要：目的改性后的牛颈静脉带瓣管道植入狗的右室流出道，1年后观察其血流动力学和抗钙化性能。方法从屠宰场取新鲜牛颈静脉，筛选后放入循环固定槽内，用0．625％的戊二醛固定1d，取出分为2组，分别置入100％2，3-丁二醇和0．3％戊二醛中保存60d，然后分组植入狗的右室-肺动脉之间，将狗的肺动脉近端结扎，饲养1年后行血流动力学检查、组织病理学观察及钙含量测定。结果心脏超声和心导管及造影检查显示戊二醛组及2，3-丁二醇组的管道瓣膜活动均良好，且跨瓣压差小。2，3-丁二醇组管道内腔及瓣膜表面发现有内皮样细胞存在。戊二醛组和2，3-丁二醛组的管道组织均存在较严重的炎性反应。2，3-丁二醇组改性后的牛颈静脉管壁平均钙含量为（8．72±0．71）ug／mg，明显比戊二醛组的平均钙含量（22．05±10．78）ug／mg低（P〈0．05）；瓣膜平均钙含量（1．38±0．86）ug／mg，与戊二醛组（0．88±0．69）ug／mg比较，差异无显著性意义（P〉0．05）。结论戊二醛鞣制的牛颈静脉带瓣管道在体实验证实其有较理想的血流动力学性能；戊二醛鞣制的生物组织材料经2，3-丁二醇改性后可明显减轻组织钙化程度。Objective To evaluate hemodynamic and anti-calcific properties of bovine jugular vein graft in right ventricular outflow tract reconstruction in dogs. Methods Fresh bovine jugular veins （BJVCs）with a natural valve of 15 to 20mm in internal diameter were tanned with 0. 625% glutaraldehyde for 1 day and preserved in 0.3% glutaraldehyde for 60 days（Group A）; and further treated in 2,3-butanediol for 60 days （Group B）. The treated BJVCs from each group were implanted in the right ventricular-pulmonary arterial position in seven dogs. The main natural pulmonary artery was ligated. After 1 year, cardiac catheterization, angiography and echocardiography, were performed prior to graft retrieval. All retrieved grafts were studied microscopically. Results Echocardiography and cardiac catheterization revealed that the motion of the valvular leaflets in both the glutaraldehyde and 2,3-butanediol post-treated conduits was satisfactory. The trans-valvular pressure gradients of both studied groups were minimal. Endothelium-like cells were observed on the entire surface of the 2,3- butanediol-fixed valved conduit retrieved at 1 year postoperatively. There was no evidence of luminal fibrous peel in any of the valved grafts. A significantly more severe inflammatory reaction was observed for the glutaraldehyde-fixed conduit than the 2,3-butanediol fixed counterpart throughout the entire course of the study. The 2,3-butanediol post-treated BJVC walls （calcium：8.72±0.71 ug/mg dry weight） had less calcification than glutaraldehyde group （calcium 22.05±10.78ug/mg dry weight respectively ） （P〈0. 05） ; There was no significant difference in the leaflets between the two groups （P〉0. 05）. Conclusions Both glutaraldehyde treated and 2,3-butanediol treated BJVCs have ideal hemodynamics properties in vivo, but the latter have less calcification.

关 键 词：生物假体 戊二醛 丁二醇 家犬 

分 类 号：R686[医药卫生—骨科学]