中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (4): 553-557.doi: 10.3969/j.issn.2095-4344.0089

• 组织构建实验造模 experimental modeling in tissue construction • 上一篇    下一篇

体外循环系统下加压灌注改善模型猪下肢血运

杨  磊1,高  磊2,王  雷2,左有为2,刘燕玲2,王江宁2   

  1. 首都医科大学附属北京世纪坛医院,1骨科,2矫形外科,北京市  100038
  • 收稿日期:2017-12-05 出版日期:2018-02-08 发布日期:2018-02-08
  • 通讯作者: 王江宁,博士,主任医师,教授,首都医科大学附属北京世纪坛医院矫形外科,北京市 100038
  • 作者简介:杨磊,男,1984年生,吉林省通化市人,汉族,首都医科大学在读硕士,医师,主要从事创伤骨科及脊柱相关疾病的研究。
  • 基金资助:

    国家自然科学基金(81473502)

Enhancement-perfusion therapy by extracorporeal circulation system ameliorates the blood supply of ischemic lower limbs

Yang Lei1, Gao Lei2, Wang Lei2, Zuo You-wei2, Liu Yan-ling2, Wang Jiang-ning2   

  1. 1Department of Orthopedics, 2Department of Orthopedic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • Received:2017-12-05 Online:2018-02-08 Published:2018-02-08
  • Contact: Wang Jiang-ning, M.D., Chief physician, Professor, Department of Orthopedic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • About author:Yang Lei, Studying for master’s degree, Physician, Department of Orthopedics, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81473502

摘要:

文章快速阅读:

文题释义:
加压灌注疗法:是指取自体血液约300 mL,用灌注液扩容后经其动脉加压回输;灌注流量一般为        340 mL/min,以保证灌注过程的高压状态。目前认为此疗法可以改善缺血下肢血供,其机制可能与血管内皮生长因子表达升高有关,从而增加动脉直径并促进毛细血管新生。
血管内皮生长因子:也称为促血管素或血管通透性因子,最早是在多种培养肿瘤细胞系中发现的一种生长因子。当时认为它可以增加微血管与小静脉血管的通透性。后来研究发现,它能够特异性的作用于血管内皮细胞,并促进血管内皮细胞的增殖,故定名为血管内皮生长因子。
摘要
背景
:课题组前期应用体外循环系统模拟体内生理环境对离体断肢进行灌注保存,并取得了一定研究成果,达到了延长体外断肢寄养时间的目的。
目的:研究体外循环系统下加压灌注疗法对改善缺血下肢血运的作用。
方法:选取健康成年雄性巴马小型猪18只,随机分为3组(n=6)。A组为正常对照组,不做任何缺血处理;B、C两组通过结扎右后肢股动脉建立下肢缺血模型;缺血4周后,C组进行加压灌注疗法,1 h/(次•d)。1周后应用数字化X光机行右后肢股动脉造影,观察各组股动脉形态及远端侧支循环变化;取各组右后肢胫前肌标本,行苏木精-伊红染色测定毛细血管密度;并用Western blot法检测血管内皮生长因子蛋白相对表达量;采用ELISA法检测血清标本中血管内皮生长因子水平。
结果与结论:①与B组相比,C组右后肢股动脉造影直径明显增加,远端侧支循环明显丰富;②C组毛细血管密度较B组明显增加(P < 0.05),但A、C两组差异无显著性意义(P > 0.05);③Western blot法显示,与A组相比,B、C 组血管内皮生长因子蛋白量均显著升高(P < 0.05),但以C组为最高(P < 0.05);④ ELISA法检测发现,与A组相比,B、C 组血管内皮生长因子血清含量均显著升高(P < 0.05),且C组最高(P < 0.05);⑤可见,体外循环系统下加压灌注疗法可以明显改善缺血下肢血运,可能为临床治疗下肢缺血提供新选择。

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程
ORCID: 0000-0002-6551-0760(杨磊)

关键词: 体外循环系统, 下肢缺血, 缺血模型, 加压灌注, 动物实验, 血管造影, 毛细血管密度, 血管内皮生长因子, 国家自然科学基金

Abstract:

BACKGROUND: In the preliminary study, extracorporeal circulation system simulated physiological environment has been applied in limb preservation, significantly prolonging the severed limb preserving time.
OBJECTIVE: To study the effect of enhancement-perfusion by extracorporeal circulation system on the blood supply of ischemic lower limbs.
METHODS: Eighteen adult Bama mini pigs were equally randomized into three groups: group A (no intervention), groups B and C (establishing the ischemic model by arteria cruralis ligation at the right posterior lower limb). At 4 weeks after modeling, the model pigs in the group C received enhancement-perfusion therapy 1 hour per day. One week later, the situations of angiography were detected by digital radiography. The tibialis anterior separated from each pig was used to test the microvessel density by hematoxylin-eosin staining. The expression levels of vascular endothelial growth factor in the skeletal muscle and serum samples were monitored by western blot and ELISA, respectively.
RESULTS AND CONCLUSION: Both diameter and distal collateral circulation of the arteria cruralis in the group C were much better than those in the group B. The microvessel density in the group C was significantly higher than that in the group B (P < 0.05), but the insignificant difference between groups A and C was found (P > 0.05). Both histionic and serum levels of vascular endothelial growth factor were significantly increased in the groups B and C compared with the group A, especially in the group C (P < 0.05). In summary, the enhancement-perfusion therapy by extracorporeal circulation system can considerably ameliorate blood supply of lower limbs, providing a promising method for treatment of ischemic lower limbs.

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程

Key words: Extracorporeal Circulation, Ischemia, Hemoperfusion, Vascular Endothelial Growth Factors, Tissue Engineering

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