生物蛋白胶外支架预防移植静脉早期损伤的实验研究  

Fibrin Glue as External Support Prevents Vein Graft Early Injury

作　　者：万力[1] 江鹏飞 高涛[1] 万于华[1] 刘季春[1] 

机构地区：[1]南昌大学第一附属医院心脏外科,江西南昌330006 [2]深圳龙华人民医院心脏内科,深圳518109

出　　处：《中国体外循环杂志》2008年第1期47-51,共5页Chinese Journal of Extracorporeal Circulation

基　　金：国家自然科学基金(30760247)

摘　　要：目的以生物蛋白胶作为外周支持,研究其对兔移植静脉的影响,从而寻找更适合临床的外支架材料。方法24只雄性新西兰大耳白兔随机分为非支架组(NS组n=12)和生物蛋白胶支架组(FS组n=12)。建立兔颈外静脉颈总动脉旁路移植术模型。FS组给予生物蛋白胶作为外支架。术后28天取出移植静脉,进行超微结构、组织病理分析和免疫组织化学分析。结果超微结构显示与NS组相比,FS组移植静脉损伤程度明显减轻。免疫组化结果显示与NS组相比,FS组移植静脉细胞增殖核抗原表达明显受到抑制;NS组内皮层损伤严重,有淋巴细胞侵润,而FS组内皮层则几乎完好无损(P<0.01);在NS组平滑肌细胞增殖活跃且向内膜迁移,FS组平滑肌细胞增殖受到抑制,且向外膜迁移;在FS组移植静脉外膜有丰富的成熟微小血管网形成,但是在NS组,微小血管数量则非常少。结论生物蛋白胶外支架能给兔移植静脉提供足够的外周支持,明显缓解移植静脉植入动脉循环后的早期损伤。该作用与保护血管内皮完整、抑制增殖细胞核抗原表达、促使平滑肌细胞向外膜迁移和形成外膜新生血管网有关。OBJECTIVE To investigate the effect of fibrin glue on preventing vein graft failure as perivenous application and explore a novel alternative external support. METHODS 24 New Zealand male rabbits were divided into non - supported group （ NS group） （ n = 12 ） and fibrin glue group （ FS group） （ n = 12 ）, All animals underwent unilateral jugular vein into common carotid artery interposition grafting and then fibrin glue was applied as perivenous support, Samples of tissues were harvested after 4 weeks and histological and immunohistochemical analysis were underwent, RESULTS Compared with NS group, an obvious relief of uhramicrostructure were showed in vein grafts of FS group. The vein grafts with perivenous support by fibrin glue demonstrated a statistically decrease in neointimal and medial hyperplasia compared with non- supported vein grafts（ P 〈 0.01 ）. Immunohistochemical analysis showed that the expression of proliferating cell nuclear antigen （PCNA） was inhibited significantly in FS group compared with NS group. Almost intact endothelium was showed in FS grafts（ P 〈0.01 ）. But in NS grafts there were severe endothelium damages where lymphocytes infiltrated. In NS grafts, the smooth muscle cells were hyperplasia and migrated to intimal, whereas in FS group, the hyperplasia of smooth muscle cells were inhibited and migrated to adventitia. We also observed the FS grafts were associated with a profound network of matured microvessels, but in NS grafts they were far less numerous. CONCLUSION Perivenous application of fibrin glue has beneficial effects on lessening early injury of vein grafts. These effects are related to intact endothelium, inhibition of PCNA expression, adventitial migration of SMC and formation of numerous microvessels.

关 键 词：生物蛋白胶 外支架 移植静脉 增殖细胞核抗原 

分 类 号：R654.3[医药卫生—外科学]