窦房结细胞自体移植治疗完全性房室传导阻滞  

Experimeatal study of SAN cells autotransplantation for treating complete heart block

作　　者：张浩[1] 宋智钢[1] 段炼[1] 姚颖龙[1] 李白翎[1] 黄盛东[1] 徐志云[1] 

机构地区：[1]第二军医大学长海医院胸心外科 解放军胸心外科研究所,上海200433

出　　处：《中华胸心血管外科杂志》2008年第6期402-405,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金资助（30672075,30700157）,第二军医大学博士创新基金资助.

摘　　要：目的探索窦房结细胞自体移植到右室前壁心肌内，治疗心脏术后完全性房室传导阻滞的可行性。方法取健康杂种犬20只，随机分为移植组和对照组，每组10只。安置电子心脏起搏器后，获取移植组犬窦房结组织并制成细胞悬液，经荧光标记后注射到移植组自体右心室前壁心肌内。对照组窦房结行Van Gieson染色，并与心耳肌组织比较。对照组右心室相同部位注射等量培养液。两周后射频消融希氏束，建立完全性房室传导阻滞动物模型，并进行心脏电生理研究。对移植组犬经股静脉应用异丙肾上腺素，研究心律变化。结果急性分离的成年犬窦房结细胞多为长梭形，细胞活性好。获取的窦房结组织行Van Gieson染色后可见其典型结构特征。建立完全性房室传导阻滞犬模型1h后，移植组心率高于对照组（P〈0．05），且此室性自主心律起源于细胞移植部位。注射异丙肾上腺素后，移植心室律变化明显（P〈0．05）。结论成年犬窦房结细胞移植到自体右室前壁心肌内，能够提高完全性房室传导阻滞后的心室律，并对异丙肾上腺素具有良好的反应性。Objective To develop a novel method for treating complete heart block by autotransplantation of sinus node cells to fight ventricular anterior wall. Methods Twenty healthy mongrel dogs were involved in the present study. The dogs were randomly assigned to transplant group or control group （n=10）. The sinus node （SN） was harvested and isolated in vitro after an electronic pacemaker was implanted and complete heart block was introduced. The SN cells from dogs of transplant group were injected to auto- genic fight ventricular wall. Commensurable culture medium was implanted to the same position of dogs in control group. Two weeks later, detailed electrophysiological study was performed. For investigating the variation of the rhythm, epinephrine was administrated through femoral vein to dogs of transplant group. Reallts Most of isolated SN ceils from dogs were thin-spindle shape, and cell activity was free. The SNs by VG stained displayed typical structurad feature. 2 weeks after cell autotransplantation, higher heart rates were achieved from transplant group than that in control group（ P 〈 0.05）. This rhythm was stable in 4 weeks and becanm faster remarkably after administration of epinephrine （ P 〈 0.05）. Conchusion SN cells of dogs autografted into right ventricular anterior wall can form new pacemaker site in ventricle and improve ventricular rate of complete heart block. This pacemaker site can also be regulated by epinephrine.

关 键 词：窦房结/细胞学 自体移植 心脏 传导阻滞 

分 类 号：R686[医药卫生—骨科学]