小型体外循环机对猪主动脉瓣置换术中心肌的保护作用

Preserving Effect on Myocardium in Porcine Aortic Valve Replacement by Minimal Extracorporeal Circulation

目的观察小型体外循环机在猪心瓣膜置换术中对心肌的保护效果。方法7只长白猪(Landrace)在小型体外循环机支持下行主动脉瓣置换术,病理观察心肌形态学改变,同时冰冻切片免疫荧光染色法测定心肌组织中补体C3b/c、先天免疫抗体IgG和硫酸肝素蛋白多糖(Heparan sulfate proteoglycans,HSPG)的含量。结果病理HE染色显示猪术前右心房与术后右心房、左心室心肌结构正常,无明显水肿损伤;免疫荧光染色显示:右心房心肌组织中补体C3b/c手术后较手术前稍增强,左心室补体C3b/c较手术前无明显改变;手术前右心房心肌组织中先天性抗体IgG荧光染色较弱,左心室手术后较手术前稍增强,而右心房较手术前荧光染色无明显改变;右心房心肌组织中硫酸肝素蛋白多糖手术后较手术前无明显改变,左心室荧光减弱。结论小型体外循环机能够对猪主动脉瓣置换术心肌起到有效的保护作用。

Objective To observe preserving effect minimal extracorporeal circulation （MECC）. Methods on myoeytes in porcine aortic valve replacement with 7 pigs were collected as experimental animals and undertook aortic valve replacement with MECC. Morphological and immunofluoreseence intensity changes of right atrial and left ventricular tissues were observed. Results HE staining showed that there were not significant changes and edema or injury of myocytes of right atriums and left ventricles between pre-operation and post-operation, lmmunofluorescence staining showed complement C3b/c in right atrial myocardial tissues after the operation were a little stronger, and innate antibody IgG were a little stronger in left ventricular myocardial tissues but similarly weak in right atrial myocardial tissues pre and post-operation. There was not significant changes in HSPG staining in pre- and post-operative right atrial myocardial tissues, but HSPG were obviously weaker in left ventricular myocardial tissues after the operation. Conclusion MECC is effective on support of porcine aorta valve replacement.