小口径脱细胞基质人工血管移植的研究

Study on vascular transplantation with small-caliber decellularized matrix vascular grafts

目的探讨脱细胞基质（DCM）人工血管用于小口径血管移植的可行性。方法40条雄性杂种犬随机分为DCM、膨体聚四氟乙烯（ePTFE）人工血管及自体颈外静脉3组行右颈总动脉置换术，彩超监测移植物通畅率。术后4、8周活体取材，标本行苏木素-伊红（UE）、免疫组织化学染色及扫描电镜检查。结果3组移植物1周通畅率（75．0％、64．3％、100．0％）差异无统计学意义（P〉0．05）；自体颈外静脉组4、8周通畅率（100．0％、88．9％）优于DCM组（56．3％、26．7％）及ePTFE组（57．1％、23．1％，P〈0．05），后两组差异无统计学意义（P〉0．05）。DCM人工血管4、8周血栓形成面积小于ePTFE人工血管，吻合口内膜内皮化程度高于后者。结论小口径DCM人工血管在抑制血栓形成及加快内皮化方面优于ePTFE人工血管。

Objective To explore the feasibility of sinai-caliber decellularized matrix （DCM） vascular grafts in vascular transplantation. Methods 40 male dogs were randomly divided into three groups, and underwent fight common carotid artery interposition with DCM （group Ⅰ , n = 16）, expanded polytet-rafluoroethylene （ePTFE） （ group Ⅱ, n = 14） vascular grafts or autologous external jugular vein （ group Ⅲ, n = 10）. Postoperative Doppler Ultrasound were done to detect the patency. Grafts were explanted at 4 and 8 weeks after implantation. The retrieved specimens were evaluated by morphology, hematoxylin and eosin （HE） stain, immunohistochemistry stain, and scanning electron microscopy. Results The patency rates at 1 week among the three groups （75.0% , 64. 3% , 100. 0% respectively） were of no difference of significance （ P 〉 0.05 ）. 4 and 8 week pateney rates of group Ⅲ（ 100.0%, 88.9% ） are both higher than group Ⅰ （56. 3% , 26. 7% ） and group Ⅱ （57. 1% , 23.1% , P〈0. 05） , however, no differences of sig-nificance were gained between the latter two （P 〉 0. 05 ）. The thrombus formation area of DCM grafts was smaller than that of eTFE grafts. DCM grafts achieved better endothelialization in the stomas neointima than ePTFE grafts within 8 weeks. Confusion Compared with ePTFE grafts, DCM grafts show superiority in reducing thrombogeneity, and improving endothelialization.