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自体静脉外支架对移植静脉内膜增生影响的实验研究

The effects of the autologous venous external stents on intimal hyperplasia of the vein grafts in rabbits

摘要:

目的 探讨自体静脉外支架对动脉缺损静脉移植后内膜增生的影响.方法 选用36只5月龄雄性新西兰大白兔,体质量2.8~3.0 kg,随机分为A组、B组和C组(n=12).切取右侧颈外静脉6 cm,等分为3段,远心段均用作移植静脉;B组以中段作为自体外支架,A组以近心段套叠中段做成双层自体外支架.游离左侧颈总动脉,中间切除长0.5 cm一段,建立动脉缺损模型,将移植静脉远近端倒置后吻合于动脉缺损,通血后行移植静脉外径测量.分别于术后2、4周切取移植静脉,行HE染色、Masson染色观察移植静脉管壁组织学变化,增殖性细胞核抗原免疫组化染色观察移植静脉平滑肌细胞增殖情况.结果 通血后移植静脉直径A组(1.6±0.3)mm,B组(2.2±0.4)mm,C组(2.6±0.6)mm(P<0.05).术后4周移植静脉内膜增生程度和内膜细胞增殖指数分别为:A组1.01±0.07和6.84±1.98,B组1.32 4±0.08和11.01±2.61,C组1.55±0.03和14.96±4.14,均为A组<B组<C组(P<0.05).结论 双层自体静脉外支架可有效地抑制移植静脉内膜增生.

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abstracts:

Objective To assess the effect of the autologous venous external stents on intimal hyperplasia of the vein grafts in rabbits. Methods Thirty-six male New Zealand white rabbits, aged 5 months and weighing 2. 8 to 3. 0 kg, were randomly divided into 3 groups: group A, group B and group C, with 12 rabbits in each group. First, a section about 6 cm long of vein was cut from the right external jugular vein of each rabbit and severed to have 3 equal-length segments. Next, each distal segment prepared for anastomosis. The proximal segment invaginating middle segment in group A and only middle segment in group B were used for the external stent. later, the left common carotid artery was separated from surrounding tissue, from it a section about 0. 5 cm long was cut away. Finally, the vein graft was inverted and end-to-end anastomosed to the two ends of the artery with a 9-0 suture. After bloodstream re-established, the diameter of each vein graft was measured. At 2 and 4 weeks postoperative,the graft veins were cut off and histologically examined by the means of HE staining and Masson staining. The smooth muscle cells (SMC) proliferation was studied by the immunohistochemical detection of proliferating cell nuclear antigen. Results After bloodstream re-established, the diameters of vein graft of group A and group B and group C were (1.6 ±0.3) mm, (2. 2 ±0.4) mm and (2.6 ± 0.6) mm respectively (P < 0.05 ) .At 4 weeks postoperative, the data of the ratio of intima to media thickness and the index of the proliferating cells of the intima were as follow: group A ( 1. 01 ±0.07 and 6. 84 ± 1. 98), group B (1. 32 ± 0. 08 and 11. 01 ± 2. 61) , group C (1. 55 ±0. 03 and 14. 96 ±4. 14). Both the data of group A were obviously less than that in group B, and that of group B was less than group C ( P < 0.05). Conclusion The autologous venous two-layer external stents inhibit intimal hyperplasia of the vein gratfs.

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作者: 郭明珂 [1] 张奇 [1] 陈占法 [1] 马利杰 [1] 吴啸波 [1] 郑占乐 [1] 张英泽 [1]
第一作者: 郭明珂
期刊: 《中华外科杂志》2010年48卷2期 138-141页 MEDLINEISTICPKUCSCD
分类号: R6
栏目名称: 论著
DOI: 10.3760/cma.j.issn.0529-5815.2010.02.015
发布时间: 2010-04-06
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