喷射心肌打孔填充不同凝胶支架后心肌孔道演变规律的实验研究  

Changes of transmyocardial channels filled with different hydrogel scaffolds after transmyocardial jet revascularization in dogs

作　　者：周大燕[1] 黄晶[1] 熊鹿[1] 郭睿[1] 吴奇[1] 容顺康[1] 江永红[1] 刘地川[1] 邓昌明[1] 

机构地区：[1]重庆医科大学附属第二医院心血管内科,重庆400010

出　　处：《第三军医大学学报》2010年第12期1282-1285,共4页Journal of Third Military Medical University

基　　金：国家自然科学基金重点项目(30527001);国家自然科学基面上项目(30670870);重庆市科技攻关重点项目(CSTC2005AA5008-5)~~

摘　　要：目的观察喷射心肌打孔填充不同凝胶支架后犬心肌孔道的演变规律以及不同凝胶支架在心肌组织中的组织相容性。方法 12只健康杂种犬,体质量9～13kg,年龄1～2岁,均分为琼脂糖凝胶(agarose hydrogel,AH)组、纤维蛋白凝胶(fibrin glue,FG)组、壳聚糖凝胶(chitosan hydrogel,CH)组,每组4只。各组用无针注射器分别喷射各种凝胶心肌打孔,于术后2、4、6周取含有孔道的心肌组织行HE、Masson染色,观察各种凝胶支架在心肌组织中的降解性和组织相容性,以及各组心肌孔道是否保留和开放。结果纤维蛋白凝胶2周内绝大部分已经降解,引起较少的炎性反应和胶原纤维增生,降解后心肌孔道闭塞,同时心内膜面发现附壁血栓形成;琼脂糖凝胶6周时仍有较多凝胶未降解,引起周围组织大量胶原增生,心肌孔道完全闭塞;壳聚糖凝胶的降解周期为4～6周,降解后可见心肌孔道开放及孔道壁内皮化。结论琼脂糖凝胶和纤维蛋白凝胶均不适合作为心肌孔道支架,而壳聚糖凝胶是一种良好的心肌孔道支架。Objective To investigate the changes of transmyocardial channels after being filled with different hydrogel scaffolds by transmyocardial jet revascularization （TMJR） in dogs and the histocompatibility of different hydrogel scaffolds in myocardium. Methods Twelve healthy mongrel dogs,with body weight 9 to 13 kg,aged 1 to 2,were randomly divided into 3 groups,agarose hydrogel group （AH group）,fibrin glue group （FG group） and chitosan hydrogel group （CH group）,4 animals in each group. Transmyocardial revascularization in different groups was performed with needle-free systems to jet out different hydrogels. Samples of myocadial tissues of 3 groups were obtained at 2,4,and 6 weeks after operation for hematoxylin-eosin （HE） staining and Masson staining to observe the degradation and histocompatibility of the 3 hydrogels in the myocardium and whether the channels in 3 groups could keep patency. Results Fibrin glue had been degraded mostly in less than 2 weeks with less inflammatory response and collagen fibers. The channels in this group were almost occluded after degradation. Moreover mural thrombus was found on the endocardial surface. There were much undegraded agarose hydrogel at 6 weeks,with the collagen fibers proliferating in surrounding tissue and the channels being occluded completely. The degradation cycle of chitosan hydrogel was observed at 4 to 6 weeks and the channels kept patency and endothelialization after degradation. Conclusion Agarose hydrogel and fibrin glue are not suitable for transmyocardial channel scaffolds,while chitosan hydrogel is a good substance for preparing transmyocardial channels scaffolds.

关 键 词：心肌 注射 喷射 凝胶类 支架 狗 

分 类 号：R318.08[医药卫生—生物医学工程] R654.2[医药卫生—基础医学]