The Experimental Study On Repair Effect Of Amniotic Membrane About Pericardium Defection After Adhesion

Objective: To explore the effect of fresh human amniotic membrane on the pericardial repair and the adhesion of the surrounding tissues of the heart in the thoracotomy on the supine rabbit moddle.Methods: A total of 54 New Zealand white rabbits were randomly divided into three groups: control,modle and HAM.The control group 18 only received thoracotomy,the pericardium without other treatment.Among 36 rabbits according to HAM applied after epicardial abrasion were randomly divided into two groups: all of the New Zealand white rabbits were successfully established,18 rabbits were successfully complete pericardial closure surgery with fresh HAM.To proferom cardiac function detection,adhesion and fibrosis grading by macro and micro evaluation,after the surgery at 30 d,60d and 180 d.Results:(1)After culturing HAM,the supernatant of the medium expressed Interleukin-10 and high expression of Matrix metalloproteinase-9,not expressing TGF-β3.The mortality rate of the control group,model group and HAM group were 0%,15% and 0% respectively,and there was no significant difference between each groups.(2)At 30 d,there was no significant difference between the three groups in cardiac function data.At 60 ds,the date of +Max d P/dt in control group,modle group and HAM group were 4643.71±532.59,3633.19±796.87 and 4661.57±474.51.The myocardial contractile performance in the HAM group is better than the model group.At 60 d,the date of +Max d P/dt in three groups were 4684.61±452.03,3044.69±379.90 and 4784.30±373.61,the performance of myocardial contraction in HAM group is better than the model group;At 180 d,the date of-Mind P/dt in three groups were-3161.58±739.91,-2278.57 ±325.89 and-3437.87±421.84,the performance of myocardial contractile in HAM group is better than model group.There was no significant values difference between the date of other cardiac function.(3)At 30 d,the score of Macroscopic evaluation system in control group,model group and HAM group were: 0,1.33±0.52 and 1.17±0.41,there is no significant difference between the three groups;At 60 ds,the score of Macroscopic evaluation system in three groups were: 0,2.5±0.55 and 1.33±0.52,there is significant difference between the model group and HAM group;At 180 ds,the score of Macroscopic evaluation system in three groups were: 0,2.4±0.55 and 1.17±0.41,there is significant difference between the model group and HAM group.(4)H&E stain of cardiac muscle and adhesion histopathological examination showed that: with the extension of observation time,the degree of myocardial adhesion in the model group was gradually increased,the Fibrosis grade was 1-2,the Inflammation grade was 0-2;with the extension of observation time,the HAM group showed better anti-adhesion effect,the Fibrosis grade was 0-1,the Inflammation grade was 0-1;Myocardial cell injury was not obvious in three groups.Conclusion: HAM has been proved to have a good effect on anti-inflammatory and anti-fibrosis,with fresh amniotic membrane repair a large of defect pericardium,that can maintain the heart be in its original position,and reduce the adhesion of myocardium and surrounding tissues.