氯吡格雷对兔主动脉球囊损伤后内膜增生的影响  

Effect of clopidogrel on intimal hyperplasia of rabit aorta injured by balloon

作　　者：徐伟平[1] 张懋贞[2] 娄樱[3] 金晔[4] 

机构地区：[1]上海第二医科大学附属新华医院心内科,上海200092 [2]上海第二医科大学公共卫生学院 [3]上海市胸科医院急诊科 [4]上海第二医科大学附属新华医院急诊科,上海200092

出　　处：《中国介入心脏病学杂志》2006年第1期40-43,共4页Chinese Journal of Interventional Cardiology

基　　金：上海市科委自然科学基金(00ZB14024)

摘　　要：目的观察氯吡格雷对家兔动脉球囊损伤后内膜增生的影响并探讨相关机制。方法将12只已通过球囊损伤主动脉内膜方法建立动脉粥样硬化斑块破裂的模型的成年雄性新西兰大白兔平均分成高胆固醇组和氯吡格雷组,另有6只健康成年雄性新西兰大白兔为对照组。测定各组家兔在主动脉内膜剥脱术前后的血清总胆固醇与甘油三酯水平,测定斑块内巨噬细胞及胶原含量变化,血浆中P-选择素的含量的变化,组织型纤溶酶原激活剂(t-PA)及纤溶酶原激活剂抑制物-1(PAI-1)活性的改变。测定血管内膜厚度及管腔狭窄度改变。结果斑块内巨噬细胞及胶原总平均值在高胆固醇组和氯吡格雷组明显高于对照组。在氯吡格雷组斑块内巨噬细胞的总平均值明显低于高胆固醇组,而斑块内胶原总平均值在氯吡格雷组高于高胆固醇组。氯吡格雷组在斑块破裂后P-选择素的含量较用药前明显降低,而高胆固醇组则明显升高。氯吡格雷组在斑块破裂后t-PA活性与用药前相比无明显变化,高胆固醇组明显下降。高胆固醇组在斑块破裂后PAI-1活性较用药前明显升高,氯吡格雷组在斑块破裂后PAI-1活性比用药前轻度下降。高胆固醇组和氯吡格雷组内膜均有不同程度增厚,但氯吡格雷组内膜及管腔狭窄度均明显低于高胆固醇组。结论氯吡格雷通过抑制血栓的形成和减少斑块内巨噬细胞的迁移和增殖来减轻动脉炎症反应,达到缩小动脉粥样硬化斑块面积、减轻内膜增生作用。Objective To study the effect of clopidogrel on intimal hyperplasia of rabit arta injured by balloon and its mechanism. Methods Twelve New Zealand rabbits were established as atherosclerosis plaques rupture models and were evenly divided in to the high-cholesterol group and the clopidngrel group. Another 6 rabbits were set as the control. Serum cholesterol and triglyceride levels were taken in the beginning, before and after surgery. Meansurement alsincluded the changes in macrophage count and collagen levels in the plaques, changes of plasma fibrinogen and P-selectin levels as well as changes in activity of t-PA and PAI-1. The changes of intima thickness and the degree of stenosis were recorded. Results Compared to the control group, the high- cholesterol group and the clopidogrel group had higher average macrophages count and collagen levels in the plaques. The clopidogrel group had less macrophages count in the plaques than the high-cholesterol group; however, the clopidogrel group had higher levels of collagen in the plaques than the high-cholesterol group. The plasma level of P-selectin reduced in the clopidogrel group after plaques rupture. The activity of t-PA remained uncharged in the clopidogrel group but increased in the high cholesterol group. Compared to pre-treamaent level, the activity of PAI-1 increased in the high-cholesterol group but reduced in the clopidogrel groups after atheroselerosis plaques rupture. The thickness of vessel intima increased in beth the high-cholesterol group and the clopidogrel group, however, the degree of intima thickening and vessel stenosis is less in the clopidogrel group compared to the high-cholesterol group. Conchusion Clopidogrel relieves inflammation reaction by inhibitting thrombegenesis and the movement of macrophages in atheroselerosis plaques, thus minimizes the degree atheroselerosis and vessel intima hyperplasia.

关 键 词：动脉粥样硬化 氯吡格雷 血管内膜 增生 

分 类 号：R654.3[医药卫生—外科学] R973.2[医药卫生—临床医学]