摘要
背景:由于种属间的差异,只有人体血管的数据,才对医学临床实际有特殊而直接的意义。目的:从人体四肢动、静脉的纵向残余应变及应力-应变关系方面探讨四肢动、静脉的血管生物力学特性对损伤修复方法选择的影响。设计:观察性实验。单位:解放军第四军医大学西京医院骨科。材料:实验于2005-09/2006-09在解放军第四军医大学西京医院完成。标本取自13例男性急性严重头颅创伤死亡患者(已签署捐献同意书),年龄18～30岁。方法:①动、静脉血管标本的切取与保存:死亡后2h内取材。用亚甲蓝在四肢主要动、静脉血管上做标记点,用游标卡尺测定各标记点间距,切取标记段血管并立即放入置于冰盒中的Kreb液中,随后转入冰箱中冷藏保存(0～5℃)。②纵向伸长率的测定:将血管置于室温下装有Kreb液的培养皿中,15min后用游标卡尺测得血管上亚甲蓝标记点间距,由实验中亚甲蓝标记点间距切取前后变化值计算获得血管纵向伸长率(实验温度20￣25℃),取材后2h内完成全部测试。③拉伸实验:取长1.0cm血管试样装入仪器后进行单向拉伸实验,血管试样始终保持在Kreb液中,取材后5h内完成全部测试(实验温度20￣25℃)。每一血管标本加载、卸载血管位移长度与对应载荷值均取3次的平均值,用实测数据拟合出应力-应变曲线。主要观察指标:四肢正常动、静脉纵向伸长率、纵向残余应变及应力-应变关系。结果:人体四肢主要动脉由近心端向远心端走行,纵向伸长率逐渐减小,静脉与之相反;四肢主要动脉与头静脉、大隐静脉纵向伸长率间大多存在明显差异(P<0.001)。四肢主要动脉由近心端向远心端走行时,应力-应变关系曲线逐渐右移,说明血管刚度值逐渐减小。而静脉则相反,曲线逐渐左移,说明血管刚度值逐渐增大。结论:人体四肢主要动脉由近心端向远心端走行,纵向残余应变逐渐减小,血管刚度值逐渐减小,静脉与之相反。提示临床修复四肢不同部位动、静脉损伤时,应考虑其相应血管的纵向生物力学特性影响,选用各自适合的修复方法。
BACKGROUND： Due to the difference of species, the data of vessel in human are particularly useful for the clinical practice.
OBJECTIVE： To analyze the longitudinal residue strain and the relationship between stress and strain of human limb arteries and veins, and explore the influence of different biomechanical properties on the repairs of limb injury.
DESIGN： Observational trials.
SETTING： Institute of Orthopaedics, Xijing Hospital of the Fourth Military Medical University of Chinese PLA.
PARTICIPANTS： The experiment was carried out in the Xijing Hospital Affiliated to the Fourth Military Medical University of Chinese PLA from September 2005 to September 2006. The specimens were taken from 13 male amputee donors（who treated for accident injury）, aged 18 to 30 years. Those tissue samples were used with the approval from the donors and offered by Xijing Hospital Affiliated to the Fourth Military Medical University of Chinese PLA.
METHODS： ①Harvest and preservation of samples： The samples were obtained within 2 hours after death. The vessels were calibrated and harvested without any large branch to avoid the influence on the mechanical property of vessel wall,and then token on major vessels of limbs with Methylene Blue. The distance between the points token on vessel was measured by vernier caliper. The token vessels were cut and taken into Kreb＇s liquid in ice casement, then were kept into freezer （0-5 ℃）. ②Longitudinal stretch ratio measurement： The vessels were taken into Kreb＇s liquid and the distance between the points token on vessel was measured by vernier caliper. The longitudinal residue strain was expressed by longitudinal stretch ratio. Lab temperature was 20-25 ℃, experiment was finished in 2 hours after sampling.③Stretch test： The vessel cut 1.0 cm was set into the instrument with Kreb＇s liquid for uniaxial tension test. The change length of each vascular specimen with or without the load and each load was measured three times and was averaged, lab temperature was 20-25 ℃, and experiments were finished in 5 hours after sampling. The curve of stress-strain was fitted by the measured data.
MAIN OUTCOME MEASURES： Longitudinal stretching ratio, residue strain and stress-strain relationship of normal limb arteries and veins.
RESULTS： The longitudinal stretch ratio of each artery decreased along vascular branch from proximal heart part to distal heart part, and that of each vein was contrast; There were significant difference in the longitudinal stretch ratios of major artery compared with those of saphena megna vein and branchiocephalicae vein （P 〈 0.001）. The curve of artery shifting right showed the stiffness of vessels decreased along vascular branch from proximal heart part to distal heart part. That of vein shifting left showed the stiffness of vessels increased along vascular branch.CONCLUSION： With the major artery of human limbs from proximal end to distal end, both the longitudinal residue strain and the vascular stiffness gradually decreases, as for the vein, the condition is contrast. It suggests that the longitudinal biomechanical property should be involved into the consideration of repairing the artery and vein injuries of different sites.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第31期6318-6320,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
