小口径脱细胞基质人工血管移植的研究

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(HE)、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.

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

Objective To explore the feasibility of smal-caliber decellularized matrix (DCM) vascular grafts in vascular transplantation.Methods 40 male dogs were randomly divided into three groups,and underwent right common carotid artery interposition with DCM (group Ⅰ,n =16),expanded polytetrafluoroethylene (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 patency 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 significance were gained between the latter two (P ＞ 0.05).The thrombus formation area of DCM grafts was smaller than that of ePTFE grafts.DCM grafts achieved better endothelialization in the stomas neointima than ePTFE grafts within 8 weeks.Conclusion Compared with ePTFE grafts,DCM grafts show superiority in reducing thrombogeneity,and improving endothelialization.