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重组水蛭素局部治疗球囊扩张术后内膜增殖和管腔狭窄的实验研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第5期
页码:
380-383
栏目:
基础研究
出版日期:
2002-09-01

文章信息/Info

Title:
Effectiveness of recombinant hirudin locally delivered via a porous balloon on lessening neointimal proliferation and luminal stenosis after balloon angioplasty in rabbits
作者:
田建伟1;  赵连友1;  郑强荪1;  刘朝中2;  江一清2
1.第四军医大学唐都医院心血管内科,陕西西安710038;2.空军总医院心血管内科,北京100036
Author(s):
TIAN Jian-wei1;  ZHAO Lian-you1;  ZHENG Qiang-sun1;  LIU Chao-zhong2;  JIANG Yi-qing2
1.Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an,Shaanxi 710038, China
关键词:
血管成形术; 气囊; 局部治疗; 重组水蛭素; 管腔狭窄; 内膜增殖
Keywords:
angioplasty; balloon;  local therapy;  recombinant hirudin(r-hirudin);  luminal stenosis;  neointimal proliferation
分类号:
R543.31
DOI:
-
文献标识码:
A
摘要:
目的 探讨重组水蛭素经多孔球囊导管局部治疗兔髂总动脉球囊扩张术后内膜增殖和管腔狭窄的作用。方法 24只纯种日本大耳白兔随机分成对照组(n=12)和重组水蛭素局部治疗组(n=12),采用兔髂总动脉球囊扩张术后内膜增殖和管腔狭窄动物模型,治疗组经多孔球囊导管于球囊扩张局部在2个大气压下给予重组水蛭素refludin (14.5×106ATU·g-1) 1 mg·kg-1,对照组给予生理盐水。术后2周和4周复查血管造影,术后4周取髂总动脉标本行HE染色、Masson三色染色、平滑肌肌动蛋白(α-actin)免疫组织化学染色和增殖细胞核抗原(PCNA)免疫组织化学染色,并进行计算机图象分析。结果 治疗组术后2周和4周血管造影平均髂总动脉直径分别较对照组扩大59.9%(P<0.01)和61.6% (P<0.01),平均髂总动脉面积分别较对照组扩大135.6%(P<0.01)和191.1%(P<0.01)。图象分析示球囊扩张术后4周治疗组髂总动脉血管腔面积较对照组扩大113.04% (P<0.01),管壁面积和内膜面积分别减少29.20% (P<0.01)和82.00% (P<0.01)。术后4周治疗组球囊扩张血管壁α-actin和PCNA免疫组化染色阳性细胞均较对照组明显减少。结论 重组水蛭素经多孔球囊导管局部治疗,可显著减轻兔髂总动脉球囊扩张术后新生内膜增殖和管腔狭窄。
Abstract:
AIM To assess the effectiveness of recombinant hirudin refludin locally delivered via a porous balloon on lessening neointimal proliferation and luminal stenosis after balloon angioplasty in rabbits. METHODS 24 rabbits were randomized into refludin group (n=12) and control group (n=12). Balloon angioplasties were performed on normal iliac arteries of rabbits. Refludin group received 1 mg·kg-1refludin [14.5×106ATU (antithrombin unit)·g-1] via a porous balloon, while control group received normal saline. Angiograms were performed at 2 wk and 4 wk after procedure. Rabbits were killed 4 wk after angioplasty. For morphometric analysis, sections of arteries were performed with HE stained, Masson stained, proliferation cell nuclear antigen (PCNA) and vascular smooth muscle cellα-actin immunohistochemical stained.RESULTS The mean common iliac arterial luminal diameter of refludin group, compare with control group, was increased by 59.9% (1.78±0.19 cmvs1.33±0.27 cm,P<0.01) at 2 wk and by 61.6% (1.59 ±0.31 cmvs0.92±0.29 cm,P<0.01) at 4 wk after angioplasty. The mean arterial area of refludin group, compare with control group, was increased by 135.6%(3.18±0.68 cm2vs1.35±0.71 cm2,P<0.01) at 2 wk and by 191.1% (2.62±0.87 cm2vs0.90±0.60 cm2,P<0.01) at 4 wk after angioplasty. At 4 wk after angioplasty, luminal areas was increased by 113.04% (1.96 ±0.52 cm2vs0.92±0.44 cm2,P<0.01), while arterial wall area and neointimal area were decreased by 29.20% (3.20±0.60 cm2vs4.52±0.84 cm2,P<0.01) and 82.00% (0.36±0.12cm2vs2.00±0.52 cm2,P<0.01) respectively. In addition, theα-actin positive cells and PCNA positive cells by staining in refludin group were less than that of control group.CONCLUSION Refludin locally delivered could significantly lessen neointimal proliferation and luminal stenosis of iliac arteries after balloon angioplasty in rabbits.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2001-07-18.
更新日期/Last Update: 2002-09-01