组织型纤溶酶原激活物生物瓣膜促纤溶作用的实验研究  

Experimental study on promoting fibrinolysis of the bioprosthetic valves loaded with t-PA gene-transfected endothelial cells

作　　者：杨丽娜[1] 汪涛[1] 季军[2] 陈亮[1] 何世琼[1] 

机构地区：[1]深圳市龙岗区人民医院心胸血管外科,广东518172 [2]深圳市孙逸仙心血管医院

出　　处：《社区医学杂志》2015年第13期5-9,共5页Journal Of Community Medicine

基　　金：深圳市龙岗区2012年度科技计划医疗卫生项目(ys2012091)

摘　　要：目的观察贴附高表达组织型纤溶酶原激活物(tissue-type plasminogen ativator,t-PA)内皮细胞的人工生物瓣膜促纤溶预防血栓及瓣膜衰坏作用。方法 2013年1月—2014年12月选择健康普通家犬26只作为研究对象,构建t-PA基因真核表达质粒体外转染犬自体血管内皮细胞并观察其产生t-PA活性;采用体外组织培养法将其贴附于人工生物瓣膜表面并给犬实施右心辅助体外循环下三尖瓣膜置换术;于术前、术后1、2、4、8和12周分别取外周静脉血检测t-PA活性和D-二聚体含量;常规病理观察瓣膜血栓形成和瓣膜钙化状况。计量资料采用方差分析,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果构建的高表达t-PA基因质粒转染犬自体内皮细胞获得了t-PA的有效表达;成功将其贴附于人工生物瓣膜表面。术后静脉血t-PA活性和D-二聚体含量检测显示,实验组两者含量明显并持续增高并直至实验观察结束,有效防止瓣膜置换术后血栓形成并减少了瓣叶钙化。结论贴附了转t-PA基因内皮细胞的人工生物瓣膜可预防犬瓣膜置换术后血栓形成和延缓衰坏。Objective To investigate the effect of bioprosthetic valves loaded with the endothelial cells transferred tissue-type plasminogen activator （t-PA） gene on the thrombosis and leaflet degeneration after valve replacement.Methods Health dogs were choosed as study objects from January 2013 to December 2014, the eukaryotic expressive plasmid for t-PA gene was constructed to transfect the dog autogenetic vascular endothelial cells in vitro and the production of t-PA was estimated.These thrombosis and leaflet calcification were observed at the end of survey period.Measurement data was processed by ANOVA,count date was used by chi squared test, P〈O.05 was considered statistically significant.Results The effective activity of t-PA produced by the endothelial cells tranfected with the t-PA gene plasmid in vitro and attachment of these cells onto the surface of the valve were obtained.The blood t-PA activity and D-dimer content were persistently increased after operation until the survey period finished.The thrombosis and the leaflet calcification after valve placement were prevented.Conclusion The bioprosthetic valves loaded with the dog vascular endothelial cells transfected with t-PA gene plasmid could prevent the thrombosis and leaflets degeneration after bioprosthetic valve replacement.

关 键 词：组织型纤溶酶原激活物 生物瓣膜置换术 血栓形成 钙化 

分 类 号：R318.11[医药卫生—生物医学工程]