同种瓣体内再内皮化的效果

目的　研究不同方法处理的心脏瓣膜组织在体内再内皮化的效果 ,试图确定最佳的再内皮化方法。方法　选用羊新鲜瓣叶 2 5个 ,分别用液氮冷冻 ,脱氧胆酸、戊二醛以及低 /高渗液、酶处理 ,比较各组瓣膜抗原性大小。将各组瓣叶分别植入羊股动脉内 ,3月后取出 ,扫描电镜观察再内皮化效果。结果　各种处理方法均可减弱瓣膜的抗原性。脱氧胆酸、戊二醛、低 /高渗液、酶处理组抗原性最低。体内再内皮化效果以脱氧胆酸、低 /高渗液、酶处理组最优。结论　经脱氧胆酸或低 /高渗液、酶处理的同种瓣抗原性低 ,受体内皮细胞易于再内皮化。

Preliminary experimental study of in vivo endothelialization of viable homograft valve

Objective To determine an optimal method of in vivo endothelialization when homograft valve (HV) leaflets are treated with different methods. Methods Twenty five fresh HV leaflets were divided into five groups randomly. The leaflets of GroupⅠ were fresh HV ones without any treatment; GroupⅡwere cryopreserved in liquid nitrogen for 1 month; Group Ⅲ was treated by DOA; GroupⅣ was treated by 25 g·L -1 glutaraldehyde; Group Ⅴ was first treated by hypotonic/hypertonic, then with an enzyme-based solution. Each HV leaflet was trimmed to 2 mm one which was cultured with lymphocyte from the recipient. In order to compare the antigenicity of HV leaflets, 3H-TdR incorporation was observed after tissue-cell coculture and stimulous index (SI) was calculated. The HV leaflets of different groups were implanted into the sheep's femorofemoropopliteal for three months; then the following procedures were done. Immunohistochemistry of Ⅷ factor correlative antigen was used to identify the cells property; observation of growth condition of EC and superficial morphosis of HV leaflets was made with scanning election microscope (SEM). Results Multiple comparison showed that SI of Groups Ⅱ, Ⅲ, Ⅳ, and Ⅴ differed significantly from Group Ⅰ(P<0.05). Group Ⅰwas highest, and SI of Groups Ⅲ, Ⅳ, and Ⅴ did not significantly differ (P>0.05), but Group Ⅲ, Ⅳ, and Ⅴ all had significant differences from GroupⅡ (P< 0.05). Effect of reendothelialization of Group Ⅲ and GroupⅤ was better. Conclusion The antigenicity of HV treated with 10 g·L -1 DOA and hypotonic/hypertonic, and enzyme-based solution is lower and the receipient ECs are ready to cover the surface of them.