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Effects of Haemopoietic Stem Cell Mobilization on Improving Vein Graft Patency

Abstract: Objective To investigate the effects of haemopoietic stem cell mobilization on vein graft patency and intimal hyperplasia of anastomosis. Methods Twentyfour New Zealand rabbits were randomly divided into experimental group and control group, 12 rabbits in each group. A double side of carotid arteryvein transplantation model was made in each rabbit. One side of vein graft was digested by 0.25% trypsin for complete endothelial denudation before transplantation. Recombinant human granulocyte colonystimulating factor was given by subcutaneous injection 24 hours after operation, once per day in successive 10 days in experimental group, saline was given in the same way in control group. Bone marrow stem cells mobilization was observed after operation, including karyote counts and mononuclear cell proportion in peripheral blood. The patency rate of vein grafts and the degree of anastomosis intimal hyperplasia were observed too. Results The karyote counts (t=8.406,P=0.000)and mononuclear cell proportion(t=31.267,P=0.000) in peripheral blood of experimental group increased significantly 5 days after operation than those in control group. The vein grafts with intact endothelium had higher patency rate in both groups. In the vein grafts with complete endothelial denudation, the patency rate were obviously lower, but it was higher in experimental group than those in control group (67% vs. 30%). In the end of experiment, the pulsatility index of the vein grafts anastomosis with complete endothelial denudation was lower in experimental group than that in control group(t=2.958,P=0.009). Pathological examination showed that various degrees of intimal hyperplasia in all anastomoses of vein grafts were observed 4 weeks after operation. The degree of anastomosis intimal hyperplasia was more severe in vein grafts with complete endothelial denudation. Compared with control group, re-endothelization occurred completely in vein grafts with complete endothelial denudation of experimental group and the degree of anastomosis intimal hyperplasia was relatively lower (Plt;0.05). Conclusion Haemopoietic stem cell mobilization can provide protective effects on vein grafts by accelerating reendothelization which might increase vein grafts patency rate in the near future after operation and reduce anastomosis restenosis caused by intimal hyperplasia.

改良超滤对心瓣膜置换术后心肺功能的影响

目的 探讨改良超滤对成人心脏瓣膜置换术后心肺功能的影响，以改善术后心肺功能。 方法 67例成人心瓣膜置换术患者随机分为改良超滤组(超滤组，n=33)和无超滤对照组(对照组，n=34), 动态观察体外循环(CPB)前、CPB停机及改良超滤结束时（对照组在CPB停机20min）氧分压(PO2)及二氧化碳分压(PCO2)、术后呼吸机辅助呼吸时间、血管活性药物用量及使用时间、左心室射血分数(LVEF)等心肺功能指标。 结果 两组的PO2 CPB前与CPB停机时相比均明显下降；超滤组在改良超滤结束时PO2明显回升，接近CPB前水平，而对照组PO2仅轻度回升，但仍明显低于CPB前；CPB停机20min时超滤组PO2高于对照组(P=0.044). CPB停机后两组PCO2轻度升高，改良超滤后PCO2轻度下降，但组内、组间比较差异无统计学意义。术后超滤组呼吸机辅助时间、血管活性药物用量及使用时间明显低于对照组(P=0.005,0.001, 0.012)。术后1周心脏超声心动图检查提示两组LVEF均较术前明显提高，但组间比较差异无统计学意义(t=0.91, P=0.367). 结论 改良超滤有利于改善成人心瓣膜置换术后早期心、肺功能。

鱼精蛋白毒性反应的防治