本文選題：心臟移植　切入點：模型　出處：《昆明醫(yī)學(xué)院》2008年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的:建立一種快速、有效的大鼠異位心臟移植模型。 方法:以雄性SD大鼠為供體,Wistar大鼠為受體,將供心的升主動脈與受體的腹主動脈行端側(cè)吻合,切除受體的左腎,將供心的肺動脈與受體的左腎靜脈以自制聚乙烯管直接插入法連接。形成受體腹主動脈→供體主動脈→冠狀動脈→心肌→冠狀靜脈→右房→右室→肺動脈→受體左腎靜脈→下腔靜脈的血液循環(huán),開放血管夾,恢復(fù)供心血供。術(shù)后每日觸摸腹部觀察移植心臟的搏動情況,移植心臟搏動24 h以上標(biāo)志移植成功。 結(jié)果:1.模型建立成功. 35例實驗成功32例,成功率91.4%,供心平均缺血時間為(37.8±1.8)~(min)。失敗的原因:吻合口出血,血栓形成。 2.病理學(xué)及電鏡結(jié)果 移植后,病理提示心臟移植后受體各臟器,移植心臟均發(fā)生明顯的病理改變。光鏡下可見心肌纖維腫脹,部分心肌纖維斷裂、紊亂,肌間隙增寬,心肌纖維間可見出血及灶性壞死,微小血管血栓形成。有較多炎性細(xì)胞浸潤。心肌冠狀小動脈管壁腫脹、增厚、官腔變小。電鏡顯示細(xì)胞皺褶、部分?jǐn)嗔?細(xì)胞器外溢,細(xì)胞核不規(guī)則,染色質(zhì)邊集,線粒體嵴模糊、部分消失、線粒體間空泡較多、線粒體內(nèi)出現(xiàn)空泡及致密顆粒。肌原纖維排列紊亂、均質(zhì)化,肌節(jié)模糊、明暗帶模糊;偶見染色質(zhì)密集,濃縮。 結(jié)論:本術(shù)式操作簡單實用,不需手術(shù)顯微鏡,易于推廣。
[Abstract]:Objective: to establish a rapid and effective model of heterotopic heart transplantation in rats. Methods: the ascending aorta of the donor heart was anastomosed with the abdominal aorta of the recipient, and the left kidney of the recipient was removed by end-to-side anastomosis with male SD rats as the donor and Wistar rat as the recipient. The donor pulmonary artery is connected to the recipient's left renal vein by direct insertion of a self-made polyethylene tube to form the recipient's abdominal aorta. 鈫扗onor aorta. 鈫扖oronary artery. 鈫扢yocardium. 鈫扖oronary vein. 鈫扲ight atrium. 鈫扲ight ventricle. 鈫扨ulmonary artery. 鈫扲eceptor left renal vein. 鈫払lood circulation of inferior vena cava, opening of blood vessel clamp, restoration of blood supply to heart, daily touching abdomen to observe the beating condition of the transplanted heart after operation, the transplanted heart was successfully transplanted for more than 24 hours. Results 1. The model was successfully established. Thirty-two cases were successful in the experiment, the success rate was 91.4%. The mean ischemic time of donor heart was 37.8 鹵1.8 min. The causes of failure were anastomotic bleeding and thrombosis. 2. Pathological and electron microscopic findings. After transplantation, pathology showed that the recipient organs and the transplanted heart had obvious pathological changes. Under light microscope, myocardial fibers were swollen, some myocardial fibers were broken, disordered, and the muscle space widened. Hemorrhage, focal necrosis, microvascular thrombosis, infiltration of inflammatory cells, swelling and thickening of the wall of myocardial coronal arterioles, and small lumen of the coronal arteries were observed in myocardial fibers. Electron microscopy showed that the cells were wrinkled, partially broken, and organelle efflux was observed. The nuclei were irregular, chromatin edge set, mitochondrial ridge blurred, partial disappearance, there were more vacuoles between mitochondria, vacuoles and dense granules appeared in mitochondria, myofibrils were arranged disorderly, homogenized, sarcomere blurred, light and dark zone blurred. Occasionally, chromatin is dense and concentrated. Conclusion: the operation is simple and practical, and it is easy to be popularized without the operation microscope.
【學(xué)位授予單位】：昆明醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2008
【分類號】：R654.2;R-332

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