中国组织工程研究

中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (2): 226-231.doi: 10.3969/j.issn.2095-4344.0690

• 可降解吸收材料 biodegradable absorbent materials • 上一篇    下一篇

人体大隐静脉桥外膜戊二醛交联对其生物力学特性的影响

方 颖1，2，刘长城1，2，顾承雄1，2，于 洋1，2，李振峰3，4，许欢明3，4，陈端端3，4   

  1. 1首都医科大学附属北京安贞医院心脏外科，北京市 100029；2北京市心肺血管疾病研究所，北京市 100029；3北京理工大学生命学院生物医学工程系，北京市 100081；4复合医工系统与健康工程工信部重点实验室，北京市 100081
  • 收稿日期:2018-07-27 出版日期:2019-01-18 发布日期:2019-01-18
  • 通讯作者: 顾承雄，主任医师，首都医科大学附属北京安贞医院心外二科，北京市 100029
  • 作者简介:方颖，男，1971年生，北京市人，回族，1995年青岛大学医学院毕业，硕士，副主任医师，主要从事冠心病的外科治疗研究。
  • 基金资助:

    国家自然科学基金(81370436，项目负责人：顾承雄)

Effects of adventitial glutaraldehyde cross-linking on biomechanical properties of human saphenous vein graft

Fang Ying1, 2, Liu Changcheng1, 2, Gu Chengxiong1, 2, Yu Yang1, 2, Li Zhenfeng3, 4, Xu Huanming3, 4,   Chen Duanduan3, 4   

  • Received:2018-07-27 Online:2019-01-18 Published:2019-01-18
  • Contact: Gu Chengxiong, Chief physician, Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China; Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
  • About author:Fang Ying, Master, Associate chief physician, Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China; Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81370436 (to GCX)

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摘要：

文章快速阅读：

 

文题释义：
戊二醛交联：戊二醛中的羰基可与胶原纤维氨基酸中的氨基反应，主要与赖氨酸和羟赖氨酸形成共价化学键，将纤维单体转变成网格状的纤维多聚体。戊二醛交联作用可改变组织的机械特性，主要表现为纤维硬度增加，抵抗纤维旋转能力增加，进而增加组织的拉伸强度和柔韧性，降低组织的延展性。
内膜增生：大隐静脉桥内膜增生主要涉及静脉壁的内膜和中层，包括平滑肌细胞的增殖和迁移、细胞外基质在内膜层的沉积。暴露于动脉系统后，薄弱静脉壁所承受的灌注压力由大约10 mm Hg骤增至100 mm Hg，持续的搏动压力启动了静脉桥压力损伤相关的病理重构过程，该病理过程逐渐进展导致内膜增厚。
 
 
背景：薄弱的静脉壁是冠状动脉旁路移植术后大隐静脉桥病变的诱发因素之一。
目的：探讨人体大隐静脉桥外膜戊二醛交联对血管生物力学特性的影响。
方法：收集冠状动脉粥样硬化性心脏病患者冠状动脉旁路移植术后剩余的大隐静脉40段，随机分A、B组，每组20段，将A组中的每段大隐静脉分成2小段，其中一段采用0.3%戊二醛溶液交联5 min，另一段不交联(对照)；将B组的每段大隐静脉分成2小段，其中一段采用0.3%戊二醛溶液交联10 min，另一段不交联(对照)。采用荧光显微镜及扫描电镜观察交联前后的血管壁微观形态；利用单轴拉伸测试检测交联前后血管的应力-应变关系、杨氏模量及破坏强度。

结果与结论：①荧光显微镜：与对照血管相比，交联血管的Ⅰ型胶原纤维呈明显压缩改变，密度显著增大，管腔面结构未见明显差异；②扫描电镜：对照血管外膜表面胶原纤维呈现典型的波浪状疏松排列，交联血管外膜表面胶原纤维呈现致密的网状排列；③单轴拉伸测试：与对照血管比较，交联5，10 min血管的应力-应变曲线明显左移，并且在高应变区(延展率为1.3-1.5)杨氏模量显著增加(P < 0.05)；与交联5 min血管比较，交联10 min血管的应力-应变曲线明显左移，并且在高应变区(延展率为1.3-1.5)杨氏模量显著增加(P < 0.05)；交联5，10 min血管的破坏强度高于对照血管(P < 0.05)；④结果表明：血管外膜戊二醛交联增加了大隐静脉血管壁强度，降低了其延展性。

ORCID: 0000-0001-5138-556X(方颖) 

关键词: 隐静脉, 冠状动脉分流术, 戊二醛, 交联试剂, 生物力学现象, 应力-应变关系, 杨氏模量, 破坏强度, 延展性, 体外实验, 生物材料

Abstract:

BACKGROUND: Poor venous wall is one of the inducing factors causing saphenous vein failure after coronary artery bypass grafting (CABG).

OBJECTIVE: To explore the effects of adventitial glutaraldehyde cross-linking on the biomechanical properties of human saphenous vein graft (SVG).
METHODS: Forty residual segments of SVG were collected from the patients undergoing CABG. Those segments were randomly divided into group A (n=20) and group B (n=20). Adventitial cross-linking was performed with 0.3% glutaraldehyde solution. Each SVG segment in group A was equally subdivided into two parts: one for adventitial cross-linking 5 minutes and the other as self-control. Each SVG segment in group B was also equally subdivided into two parts: one for adventitial cross-linking 10 minutes and the other as self-control. The ultra-structural changes of the venous wall with or without cross-linking were observed by fluorescence microscope and scanning electron microscope. The SVG segments in two groups underwent the uniaxial stretch test to detect the stress-strain relationship, Young’s elastic modulus and breaking strength of SVG segments receiving different processing.
RESULTS AND CONCLUSION: (1) Fluorescence microscope: Compared with the SVGs of self-control, cross-linked SVGs mainly presented with compacted adventitial monomer of collagen and increased density of type I collagen, without obvious ultra-structural changes in the lumen surface. (2) Scanning electron microscope: The adventitial collagen fibers in the self-control segments showed a typical wavy loose arrangement, while the adventitial collagen fibers in the cross-linked segment appeared to have a dense fibrous network. (3) Uniaxial stretch test: Compared with the self-control parts, the stress-stretch ratio curve in the cross-linked parts in the two groups was shifted to the left remarkably, and in the high strain region (stretch ratio 1.3-1.5), the Young’s elastic modulus was also increased significantly (P < 0.05). Compared with the SVGs in the cross-linking 5 minutes, the stress-stretch ratio curve in the SVGs in the cross-linking 10 minutes was shifted to the left remarkably, and in the high strain region (stretch ratio 1.3-1.5), the Young’s elastic modulus was also increased significantly (P < 0.05). The breaking strength of cross-linked SVGs was higher than that of self-control SVGs in the two groups (P < 0.05). To conclude, adventitial glutaraldehyde cross-linking reinforces venous wall and reduces the ductility of human SVG.  

Key words: Glutaral, Cross-Linking Reagents, Saphenous Vein, Coronary Artery Bypass, Tissue Engineering

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