嵴内型室间隔缺损封堵器的组织相容性研究  

Study of the Histocompatibility of the Occluder for Intra-crista Type of Interventricular Septal Defect

作　　者：周达新[1] 管丽华[1] 王晓彦[1] 王宜青[1] 黄国倩[1] 潘翠珍[1] 葛均波[1] 

机构地区：[1]复旦大学附属中山医院心内科,上海200032

出　　处：《中国临床医学》2007年第6期753-756,共4页Chinese Journal of Clinical Medicine

基　　金：上海市科委基金资助(编号:034119903)

摘　　要：目的:观察动物体内嵴内型室间隔缺损(IVSD)封堵器的组织相容性以及其对周围结构的影响.观察封堵器表面、内部在不同时期组织生长情况。方法:使用主动脉-大隐静脉近端吻合器打孔器,在非体外循环的情况下制成嵴内型动物模型,使用嵴内型室间隔缺损封堵器进行封堵。分别在术后4周、12周、24周处死动物,在大体和显微镜下观察其组织相容性和对周围结构的影响以及封堵器表面、内部组织生长情况。结果:10只成功建立了室间隔缺损模型,7只为IVSD,并进行IVSD的封堵,6只动物成功封堵。术后24h行超声心动图检查示封堵器位置良好,对主动脉瓣无影响。大体标本观察:4周、12周、24周封堵器对动脉瓣膜无影响,表面无血栓形成,4周封堵器大部分被薄薄一层组织所覆盖,封堵器清晰可见,封堵器内部也有组织生成。12周、24周封堵器呈毛玻璃状,表面被新生组织覆盖,新生组织与正常心内膜相连,封堵器内部的高分子物质与增生的组织一起形成坚实的组织块,无弹性。光镜下:4周表面可见红细胞渗出,纤维素附着,下层可见纤维素增生。12周可见封堵器表面有完整的新生内皮细胞,表面光滑,无红细胞渗出、纤维素附着,内部可见聚酯纤维断裂,聚酯纤维断裂处可见大量的巨核细胞和炎性细胞。24周封堵器表面光滑,无血栓形成,可见内皮细胞,下层可见纤维母细胞增生,胶原形成,还可见纤维组织增生伴淋巴细胞、浆细胞及少量嗜酸性粒细胞浸润,毛细血管增生。结论:新型嵴内型的VSD封堵器,在动物体内组织相容性好,对主动脉瓣未造成的影响,与以往的VSD封堵器相比显示出一定的优势。Objective： to observe the histocompatibility and influence to the peri-issue of the occluder for intra-crista type of inerventricular septal defect （IVSD） in animal models, such as the growth condition of tissue on surface and in internal of the occluder. Methods：we use Aorta and great saphenous vein stapler-puncher, without extracorporeal circulation, to produce the animal models of IVSD successfully. Execute the animals separately 4weeks, 12weeks and 24 weeks after the operation. Observe the histoeompatibility arid the influence of the occluder to the peri-issue as well as the growth condition of tissue on surface and in internal of the occluder, maeroscopy as well as microscopy. Results： 10 models are set successfully, 7 are IVSD, all of which carried out the occlude operation later, and 6 succeded. Echocardiography examinations 24 hours post the operation show the oecluders in good position, without influence to the aortic valves. Observed by macroscopy： the occluders have no influence to the aortic valves in 4wk, 12wk, 24wk post operation, no surface thrombosis. When 4wk, Most of the occluders can be clear observed, though covered by a superficial wrap of tissue, tissue also form in the interior of the occluders. When 12wk and 24wk, the occluders show an appearance of frosted glass, covered by neogenetic tissue. Linked with normal endocardium, the neogenetic tissue together with giant molecule substance interior of the occluder, form the substantial tissue block, which is lack of elasticcity. Observed by microscopy ： when 4wk, the surfaces of the occluders show exudation of RBC, coherence of cel lulose, while the underlayer cellulose hyperplasy . when 12wk, the surfaces show complete neogenetic endotheliocyte, smooth surface without exudation of RBC or coherence of cellulose. And the interior show breakage of polyester fiber, around the breakage gather a lot of megakaryocytes and inflammatory cells. When 24wk, the surfaces are smooth with no thrombosis, but endotheliocytes exist, and the underl

关 键 词：动物模型 嵴内型室间隔缺损 封堵器 

分 类 号：R541.108[医药卫生—心血管疾病]