[基础医学]第6章 组织工程人工器官与组织再生.doc
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1、第6章 医用高分子材料的应用:-人工器官与组织再生Artificial Organ & Tissue Regeneration内容l 人工器官概述- 器官移植与人工器官,人工器官的分类l 范例:人工血管 & 人工心脏瓣膜- 心血管结构,人工血管及其应用、要求、材料,人工心脏瓣膜l 组织再生:组织工程- TE原理,TE三要素,支架,细胞/干细胞21Review: tissue & organl Tissue is a biological structure made up of cellsof the same type. Cells of the same phenotype ( i.e.,
2、 same genesexpressed). An aggregation of morphologically similar cellsand associated extracellular matrix actingtogether to perform one or more specificfunctions in the body. There are four basic types of tissue: muscle,nerve, epithelia, and connective.l An organ is a structure made up of 2 or more
3、tissuesthat can together perform a more complex functionthan a single tissue.3器官和组织的缺失或衰竭是人类保健中发生最频繁、最具危害性的问题之一pancreatic carcinoma42Solutions ?l Transplantation is the act of transferring anorgan, tissue, or cell from one place to another.l The field of organ transplantation has maderemarkable prog
4、ress in the past many years.Transplantation has evolved to become thetreatment of choice for end-stage organ failureresulting from almost any of a wide variety ofcauses.l Transplantation of the kidney, liver, pancreas,intestine, heart, and lungs has now becomecommonplace in all parts of the world.5T
5、ransplantation Types Broadly speaking, transplants are dividedinto three categories based on thesimilarity between the donor and therecipient: Autotransplants (自体移植) Allotransplants (同种移植) Xenotransplants (异种移植)63l Autotransplants involve the transfer of tissue ororgans from one part of an individua
6、l to another partof the same individual. They are the most commontype of transplants and include skin grafts and veingrafts for bypasses. NO immunosuppression isrequired.l Allotransplants involve transfer from one individualto a different individual of the same species themost common scenario for mo
7、st solid organtransplants performed today. Immunosuppression isrequired for allograft recipients to prevent rejection.l Xenotransplants involve transfer across speciesbarriers. Currently, xenotransplants are largelyrelegated to the laboratory, given the complex,potent immunologic barriers to success
8、.7供体缺乏是器官移植治疗面临的最主要问题据卫生部的统计数据,我国每年等待器官移植的患者超过150万人,但其中只有1万人能够幸运地得到供体,供需比1:150,超过99%的患者只能在等待中逐渐绝望和死去84Any other approaches ?人工器官。是医用高分子材料的主要发展方向9l Artificial Organs:用人工材料制成,能部份或全部代替人体自然器官功能的装置105Artificial Pancreas For people with type 1 diabetes Consists of: A continuous glucose monitor (CGM) Insul
9、in Pump (programmed by acomputer algorithm) Algorithm calculates the insulindosage required from the bloodglucose reading Tells the pump to deliver the neededamount of insulin11Artificial Organsl An artificial organ is a man-made device that is implanted orintegrated into a human to replace a natura
10、l organ, for thepurpose of restoring a specific function or a group of relatedfunctions so the patient may return to as normal a life aspossible . The replaced function doesnt necessarily have tobe related to life support, but often is.l Reasons to construct and install an artificial organ mightincl
11、ude: Life support to prevent imminent death while awaiting atransplant (e.g. artificial heart) Dramatic improvement of the patients ability for self care(e.g. artificial limb) Improvement of the patients ability to interact socially (e.g.cochlear implant) Cosmetic restoration after cancer surgery or
12、 accident12http:/en.wikipedia.org/wiki/Artificial_organ6l 当人体器官病损而用常规方法不能医治时,有可能给病人使用一个人工制造的器官来取代或部分取代病损的自然器官,补偿或修复或辅助其功能。人工器官是暂时或永久性地代替身体某些器官主要功能的人工装置。l 人工器官是生物医学工程专业中一门新的学科。它主要研究模拟人体器官的结构和功能,用人工材料和电子技术制成部分或全部替代人体自然器官功能的机械装置和电子装置。1320世纪80年代以来,人工器官的研究和应用迅速发展,可以说,人体除大脑尚无人工大脑替代外,几乎人体各个器官都在进行人工模拟研制中,其中
13、有不少人工器官已成功地用于临床。人工器官的进步有赖于材料尤其是高分子材料的进展。在人工器官制造中,有机高分子材料占据了相当大的比例。据统计,世界上应用医用高分子有近百个品种,近两千种制品,大约消耗高分子材料的1015,并且每年以812的速度在增长。147加拿大科学家制成迄今为止最复杂人造大脑这种“大脑”能够处理视觉线索,并在纸上复制它们简图展示Spaun的处理信息的过程1530 Nov 2012, Vol. 338 no. 6111 pp. 1202-1205 目前医用高分子材料制成的人工器官中,比较成功的有人工血管、人工食道、人工尿道、人工心脏瓣膜、人工关节、人工骨、整形材料等。 巳取得重大
14、研究成果,但还需不断完善的有人工肾、人工心脏、人工肺、人工胰脏、人工眼球、人造血液等。 另有一些功能较为复杂的器官,如人工肝脏、人工胃、人工子宫等,则正处于大力研究开发之中。168人工器官按功能分为11类I.支持运动功能的人工器官,如人工关节、人工脊椎、人工骨、人工肌腱、人工假肢等。II. 血液循环功能的人工器官,如人工心脏及其辅助循环装置、人工心脏瓣膜、人工血管、人工血液等。III. 呼吸功能的人工器官,如人工肺(人工心肺机)、人工气管、人工喉等。IV. 血液净化功能的人工器官,如人工肾(血液透析机)、人工肺等。V. 消化功能的人工器官,如人工食管、人工胆管、人工肠等。VI. 排尿功能的人工
15、器官,如人工膀胱、人工输尿管、人工尿道等。VII. 内分泌功能的人工器官,如人工胰。VIII. 生殖功能的人工器官,如人工子宫、人工输卵管、人工睾丸等。IX. 神经传导功能的人工器官,如心脏起搏器、膈起搏器等。X.感觉功能的人工器官,如人工视觉、人工听觉(人工耳蜗)、人工晶体、人工角膜、人工听骨、人工鼻等。XI. 其他类,人工硬脊膜、人工皮肤等。17l一些用于人工器官的重要医用高分子材料polysiloxane (PDMS)polyethylene (PE)polypropylene (PP)polyurethane (PU)polytetrafluoroethylene (PTFE)poly
16、(vinyl chloride) (PVC)polyamide (PA)poly(methyl methacrylate) (PMMA)polyacetal (POM)polycarbonate (PC)poly(ethylene terephthalate) (PET)polyetheretherketone (PEEK)polysulfone (PSU)189The top 10 causes of death worldwideplaque formation in thecoronary arteryblood vessel blockagewithin the brain冠心病脑血管
17、疾病Vascular diseases, both at the heart and in the arterial tree (periphery),are very common among most of the people, as they grow older.192010Myocardial InfarctionPlaque formation inside the blood vessel to disrupt the blood supply to LVto induce MIMyocardial infarction means that part of the heart
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