循环内皮细胞参与人工血管体内内皮化过程的动物实验(英文)

Circulating endothelial cells participate in the in vivo endothelialization of vascular prosthesis:An animal experiment

背景:已有实验表明,通过自体血管内皮细胞种植于人工血管腔面提高了血管移植的通畅率。骨髓内皮细胞衬里人工血管是否有利于人工血管体内的内皮化过程?目的:通过骨髓内皮细胞衬里人工血管间置移植的动物实验观察人工血管内皮化效果。设计:观察对比动物实验。单位:上海市第六人民医院。材料:实验于2000-09/2001-10在上海市第六人民医院完成。选用20只上海地区杂种犬,犬龄1.0～2.0岁,雌雄不拘,体质量(18.7±2.3)kg方法:分离犬骨髓单核细胞,ePTFE人工血管以2种规格(4 mm×4cm和8mm×5cm)完成内皮化。颈总动脉移植:选用10只实验犬切除颈总动脉主干4cm,将直径4mm长4cm的ePTFE人工血管间置移植于双侧颈总动脉,内皮化人工血管为实验组,未经内皮化人工血管为对照组,每组5只。术后2周及2个月采用彩色超声检查移植血管通畅率及血流速率。下腔静脉移植:选用剩余10只实验犬,6只为实验组,实验犬麻醉下将下腔静脉游离约8～10 cm,阻断两端,切除约5 cm,取直径8 mm长5 cm内皮化ePTFE人工血管,以5-0 Prolene作端端吻合,4只为对照组,以相同规格ePTFE人工血管为移植血管。术后2个月测定血管通畅率。同时与上述时间点计算各组移植血管内皮细胞覆盖率及内膜厚度。主要观察指标:①各组实验犬不同时间点移植血管通畅率及血流速率。②各组移植血管内皮细胞覆盖率及内膜厚度。结果:①颈总动脉移植术后2周和2月实验侧通畅率分别为100% (5/5)和60%(3/5).同期对照侧通畅率分别为40%(2/5)和0%(0/5)。术后2个月实验组平均血流速率明显小于对照组(P<0.05)。下腔静脉移植实验组和对照组2月移植血管通畅率为83%(5/6)和50%(2/4)。②颈总动脉及下腔静脉移植术后2周实验组血管腔面内皮细胞覆盖率大于对照组,差异有显著性意义(P<0 05),术后2个月实验组血管内膜厚度小于对照组,差异有显著性意义(P<0.05)。结论:骨髓内皮细胞衬里的ePTFE人工血管在体内能较快完成内皮化过程,能抑制内膜增生;循环内皮细胞作为内皮细胞的潜在来源,具有一定临床应用价值。

BACKGROUND： Experiments have demonstrated that autologous vascular endothelial cells if transplanted onto artificial vascular cavosurface, can enhance the patency rate of vasotransplantation. Whether seeding of prostheses interposition grafts with bone marrow-derived endothelial cells is effective for in vivo endothelialization of artificial vessels remains unclear. OBJECTTVE ： To observe the effect of endothelialization of vascular prosthesis by seeding prostheses interposition grafts with bone marrow-derived endothelial cells in animals. DESIGN ： A controlled animal experimental study. SETTING： Shanghai Sixth People＇s Hospita. MATERIALS： This study was carried out in the Shanghai Sixth People＇s Hospital between September 2000 and October 2001. Twenty hybrid dogs from Shanghai, of either gender, aged 1.0 to 2.0 years old, weighing （18.7±2.3） kg, were involved in this study. METHODS： Bone marrow-derived mononuclear cells were isolated from the dogs. The endothelialization of ePTFE prostheses interposition grafts （4 mm×4 cm and 8 mm×5 cm）was carried out. Common carotid artery transplantation： Ten laboratory dogs were involved. Common carotid artery of 4 cm was resected from each dog. ePTFE prostheses interposition grafts of 4 mm×4 cm was transplanted into the bilateral common carotid artery, and prostheses interposition grafts were performed endothelialization, namely experimental group. Those prostheses interposition grafts, which were not performed endothelialization, were named as control group. Five dogs were used in each group. Patency rate and blood flow rate of transplanted vessels were detected with a color ultrasonograph 2 weeks and 2 months after operation. Inferior caval vein transplantation： Six of the rest 10 dogs were used for experiments. Under the anesthesia, 8-10 cm inferior caval vein was dissociated from each dog. Its two ends were blocked, and about 5 cm inferior caval vein was resected, ePTFE endothelialized vascular prosthesis with 8 mm in diameter and 5 cm in length was anastomosed end to end with 5-0 Prolene. The other 4 dogs were used for control experiment, ePTFE vascular prosthesis with the same specification was used as prostheses interposition graft. Vascular patency rate was determined 2 months after operation. At the same time, coverage rate and intimal thickness of transplanted vascular endothelial cells and vascular intimal thickness were determined. MAIN OUTCOME MEASURES ： ① The patency rate and blood flow rate of transplanted vessels at different time points. Coverage rate of transplanted vascular endothelial cells and vascular intimal thickness. RESULTS： ① At 2 weeks and 2 months after common carotid artery transplantation, the patency rate of experimental side was 100%（5/5）and 60%（3/5）, respectively, and that of control side was 40%（2/5）and 0%（0/5）, respectively. At postoperative 2 months, the mean blood flow rate in the experimental group was obviously smaller than that in the control group （P 〈 0.05）. At 2 months after inferior caval vein transplantation, the patency rate of experimental group and control group was 83%（5/6）and 50%（2/4）, respectively. ②At 2 weeks after common carotid artery transplantation and inferior caval vein transplantation, the coverage rate of vascular endothelial cells in the experimental group was significantly larger than that in the control group, separately （P 〈 0.05）. At 2 months after each transplantation, the vascular intimal thickness in the experimental group was significantly smaller than that in the control group （P 〈 0.05）. CONCLUSION ： Seeding of ePTFE prostheses interposition grafts with bone marrow-derived endothelial cells can rapidly accomplish in vivo endothelialization and inhibit intimal hyperplasy; Circulating endothelial cells, as the potential source of endothelial cells, have certain clinical application values.