有活性细胞的生物瓣的构建  

Construction of Bioprosthetic Heart Valve with Viable Cells

作　　者：吴向阳[1] 朱洁 刘迎龙[1] 曹学文[3] 

机构地区：[1]中国医学科学院,阜外心血管病医院外科,先心病研究室,北京,100037 [2]甘肃省平凉地区卫生学校,平凉,744000 [3]兰州医学院,第二附属医院,胸心外科,兰州,730030

出　　处：《生物医学工程学杂志》2003年第4期750-753,共4页Journal of Biomedical Engineering

基　　金：国家高技术研究发展计划资助项目(863计划;2 0 0 1AA2 160 61)

摘　　要：理想的人工心脏瓣膜必须以瓣膜内具有活的有正常功能的细胞为基础 ;目前临床应用的经液氮深低温保存的同种瓣虽有活性细胞 ,但经移植前多种因素的影响后细胞数量、活性及功能会受到不同程度的影响 ,这种瓣膜被植入受体体内后大多数细胞会在短期内自溶或凋亡 ,失去重塑细胞外基质的能力 ;残留的活性细胞会引起受体的体液及细胞免疫 ;细胞损伤或死亡后所释放的蛋白酶会引起瓣膜基质的降解 ,致耐久性下降 ;无活性细胞或细胞残核则成为钙化的中心而引起瓣膜钙化。无细胞的天然瓣膜基质经受体细胞再细胞化后具备活性细胞和一定的细胞功能两个条件 ,可望有效的解决生物瓣的耐久性 ,构建出具有生长、修复、塑型潜能的人工心脏瓣膜。The ideal valve substitute should have cellular viability. Cryopreserved allograft has cellular viability in some degree, but the quantity, viability and function of the cells are affected by some preexisted factors such as chemical injury, hypoxia during valve processing and injury at the time of implantation. Early celluar autolysis and apoptosis take place not long after implantation, the implanted valve thus loses significant capacity to grow, remodel, or exhibit active metabolic functions. The viable donor cells are antigenic and capable of eliciting immune response, including antigenic and antigen specific T cells. Calcification appears to originate in residual nonviable cells and their fragments. Proteinases released from endothelial and fibroblast cells of allograft heart valve will lead to the destruction of the valve matrix.One of the focuses of creating an ideal heart valve is the progressive recellularization of the valve matrix by the autologous cells. The acellular valve matrix,after being recellularized, has two characters: cellular viability and normal cellular function,which are the bases of creating ideal bioprosthetic valve with the potentiality of growing, repairing and remodeling.

关 键 词：活性细胞 生物瓣 构建 同种瓣 瓣膜基质 再细胞化 

分 类 号：R318.1[医药卫生—生物医学工程]