自体移植静脉内皮细胞的缺血安全时限  

Safe ischemic time of endothelial cells in autologous vein graft

作　　者：王明松[1] 邹良建[1] 黄盛东[1] 徐志云[1] 邹榕江[1] 

机构地区：[1]解放军第二军医大学长海医院胸心外科,上海市200433

出　　处：《中国组织工程研究与临床康复》2007年第8期1401-1404,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：军队"十五"医药卫生科研基金重点资助项目(01Z063)~~

摘　　要：目的:观察离体后不同缺血时间自体移植静脉内皮细胞的损伤程度,分析移植静脉内皮细胞缺血的安全时限。方法:实验于2005-07/2005-12在中国人民解放军胸心外科研究所完成。选择健康成年家犬29只,购自解放军第二军医大学实验动物中心。①不同缺血时间移植静脉内皮细胞损伤实验:按随机数字表法选取5只家犬,取双侧股静脉,按离体后0min,30min,60min,90min4个时间点行扫描电镜及透射电镜检查,观察内皮细胞的损伤程度,Ⅰ级正常,Ⅱ级轻度,Ⅲ级中度,Ⅳ级重度,Ⅴ级坏死,将Ⅰ,Ⅱ,Ⅲ级损伤归类为可逆性损伤;将Ⅳ,Ⅴ级损伤归类为不可逆损伤。②自体移植静脉内皮细胞缺血安全时限实验:将剩余24只家犬建立犬股静脉离体不同时间(30min,60min,90min)的自体移植模型,在术后1d,3d,7d,14d再次手术取出静脉,行扫描电镜检查,比较不同时间点移植静脉内皮覆盖率。结果:①缺血0min,30min,60min,90min组(n=60)不可逆性损伤内皮细胞数分别为12,6,28,33,缺血60min、90min组内皮细胞的损伤程度明显重于缺血0min和30min组。各组的内皮细胞覆盖率比较差异无显著性意义(P>0.05)。②24只模型犬全部存活,切口愈合佳,无红肿、溢脓或裂开。③移植术后1d,14d,缺血30min,60min及90min组内皮细胞覆盖率差异无显著性意义(P>0.05),而术后3d,7d,缺血30min组的内皮细胞覆盖率显著高于缺血60min及90min组[(62.21±3.52)%,(40.09±2.56)%,(36.17±4.55)%(P<0.01);(82.31±3.76)%,(60.22±3.23)%,(59.39±4.27)%(P<0.01)]。结论:缺血60min后静脉内皮细胞的超微结构会发生明显的不可逆性损害,移植静脉内皮细胞缺血的安全时限是60min。AIM： To investigate the injury degree of different ischemic times on endothelial cells, and make certain the safe ischemic time of endothelial cells in autologous vein graft. METHODS： The experiment was carried out in the Chinese PLA Institute of Cardiothoracic Surgery between July and December in 2005. A total of 29 adult dogs were enrolled from the Experimental Animal Center of the Second Military Medical University of Chinese PLA. ①Experiment of endothelial cell injury at different ischemic times： Five dogs were selected randomly to harvest the femoral vein, and injury degree of endothelial cells were examined at 0, 30, 60, 90 minutes by scanning and transmission electron microscopy. Reversible injury included Ⅰ, Ⅱ, Ⅲgrades of injury, while irreversible injury included Ⅳ,Ⅴ grades of injury.②Experiment of the safe ischemic times in autologous vein graft： Other 24 dogs were adopted to establish the dog model of autologous vein graft at different ischemic time. At 1, 3, 7, 14 days after implantation, the vein grafts were harvested and examined with scanning electron microscopy to compare the covering percentage of endothelium monolayer at different time points. RESULTS： ①The endothelial cells of irreversible injury were 12, 6, 28, 33 at ischemia groups of 0, 30, 60, 90 minutes; the endothelial ultrastructure was more seriously damaged in 60-minute and 90-minute ischemia groups than that in 0-minute and 30-minute groups but the covering percentage of endothelium monolayer was similar in each group （P 〉 0.05）.②All 24 dogs were survived well, without any swelling, pyorrhea or fissuration. ③At day 1 and day 14 after operation, there was a significant difference about the covering percentage of endothelium monolayer among 30-minute, 60-minute and 90-minute ischemia groups （P 〉 0.05）; At day 3 and day 7 after operation, the covering percentage of 30-minute ischemia group was significantly higher than that of 60 and 90 minute groups [（62.21±3.52）, （40.09±2.56）, （

关 键 词：静脉/移植 内皮/细胞学 局部缺血 

分 类 号：R617[医药卫生—外科学]