家兔颈总动脉剥脱术后新生内膜增殖和血管重塑动态变化模型的研究  

Dynamic model of neointima proliferation and remoulding of vascular wall after common carotid artery denudated in rabbits

作　　者：张新平[1] 庞月华 冯义伯[1] 付作林[1] 史春志[1] 谷翔[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院心内科,湖北武汉430022 [2]新疆乌鲁木齐市友谊医院

出　　处：《中国医师杂志》2006年第6期759-762,共4页Journal of Chinese Physician

摘　　要：目的探索再狭窄（RS）的发病机制进行干预研究，复制家兔颈总动脉内膜损伤后不同时间点内膜增殖和血管重塑动态变化模型。方法选用家兔70只行颈总动脉内膜球囊损伤，分别检测未损伤侧（N）和损伤后1d、3d、5d、7d、14d、28d、35d管腔面积（LA）、内膜和中膜厚度及面积、以及外弹力膜横截面积（EELA）。结果损伤后1d可见动脉内皮剥脱；3d管腔内表面可见增殖的血管平滑肌细胞（VSMC）；5～7d新生内膜（NI）形成并增厚，14d以后NI厚度及面积逐渐增加，至35d达最大．同时细胞外基质（ECM）也逐渐增加。损伤后3～14d中膜厚度及面积逐渐增加，其中14d中膜面积明显大于N，28-35d趋于降低。LA于损伤后5～7d开始减少；14d以后明显小于N。损伤后1-7dEELA逐渐增大，至14d达最大，28d后开始回缩。结论家兔颈总动脉球囊损伤能较好的模拟RS形成过程，内膜增殖与血管重塑均是RS形成的主要病理机制。Objective To study the mechanism of restenosis following pereutaneous transluminal coronary angioplasty （ PICA）, and to replicate a dynamic model of cell proliferation and remoulding of vascular wall at different time points in rabbits after intimal injury. Methods The model of restenosis in common carotid artery was established by balloon injury in 70 rabbits. The indexes such as lumen area, thickness and area of intima and media, and cross sectional area bounded by the external elastic lamina （EELA） were respectively measured by computer image analysis technology at the 1st, 3rd, 5th, 7th, 14th, 28th and 35th day after the injury. Results Endothelial cells were denudated at the 1st day after injury. The proliferation of vascular smooth muscle cell （VSMC） was detected on the surface of lumen at 3 days after injury. At the 7th day after injury, the neointima was formed and continuously thicken. The thickness and area of the neointima as well as extracellular matrix were gradually increased after 14 days, and were maximal after 35 days. The thickness and area of media were also gradually increased during 3 - 14 days and decreased after 28 days. Compared with non-injured vessel, the medial area was obviously increased at the 14th day. The lumen area was decreased at the 5th -7th day after injury and was obviously less than that of non -injured vessel after 14 days. The EELA was gradually increased at the 1st -7th day after injury, and reached its maximum at the 14th day. The EELA was declined gradually after 28 days. Conclusion The progress of restenosis（RS） can be simulated through the model of restenosis in common carotid artery of rabbit established by balloon injury. The intimal proliferation and vascular remodeling are the leading pathogenesis of restenosis.

关 键 词：颈动脉内膜切除术 血管内膜 

分 类 号：R-332[医药卫生] R654.3