血管外支架预防静脉桥再狭窄的实验研究  

Experimental Study of Saphenous Vein Grafts Restenosis Prevention by External Stents

作　　者：潘文标[1] 郑家豪[1] 连锋[1] 傅于捷[1] 吴学军[1] 张谷兰[1] 王小妹[1] 

机构地区：[1]上海交通大学医学院仁济医院胸心外科,上海200001

出　　处：《上海交通大学学报（医学版）》2006年第10期1150-1153,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市教委基金(03BK21);上海市浦东新区科技局基金(Pkj2002-60)资助项目

摘　　要：目的以猪大隐静脉-颈总动脉间置动物模型为基础，观察涤纶血管外支架支持预防静脉桥血管内、中膜增生的作用。方法20～25kg普通长白猪10只，行双侧大隐静脉-颈总动脉端端吻合，实验侧静脉桥放置涤纶外支架。术后28d取出双侧静脉桥血管，分别进行组织学观察和免疫组化检测，图像定量分析获得静脉桥内、中膜厚度以及增殖细胞核抗原（PCNA）和血小板衍生生长因子（PDGF）的表达情况。结朵对照组和实验组静脉桥血管内膜厚度分别为（0．4269±0．0794）mm和（0.1371±0．039）mm（P〈0．05）；中膜厚度分别为（0．4601±0．0628）mm和（0．259±0．0178）mm（P〈0．05）。对照组和实验组PCNA、PDGF阳性细胞率分别为（13．20±2．17）％vs（2．34±0．68）％和（13．10±1．39）％vs（2．44±0．25）％（P均〈0．01）。结论非限制性涤纶血管外支架可以显著抑制大隐静脉桥血管新内膜及中膜的增生，可能籍此预防静脉桥的再狭窄。Objective To evaluate the effect of external stents on preventing vein graft neointima formation and medial thickening with non-restrictive marcroporous polyester stent around vein grafts in pigs. Methods Ten ＂white race＂ pigs with body weight of 20 -25 kg were included in the study. All the animals were performed bilateral saphenous vein interposition grafting into carotid artery. In each animal, a macroporous stent was placed around a graft on one side and an unstented graft on the opposite side as control. Twenty-eight days after surgery, animals were taken to remove grafts, and histological and immunohistochemical examinations were performed. Results Stents significantly reduced neointimal thickness from （0. 4269 ± 0. 0794 ） mm to （0. 1371 ± 0. 039 ） mm （ P 〈 0.05 ） and medial thickness from （0. 4601 ±0. 0628） mm to （0. 259 ± 0. 0178 ） mm （P 〈 0.05）. Stents significantly reduced the percentage of cells expressing platelet-derived growth factor （PDGF） and proliferating cell nuclear antigen （ PC NA）. Mediaintimal PCNA index was reduced from（13.20±2.17）% to （2.34 ±0.68）%（P〈0.01）, and PDGF index was reduced from （ 13.10 ± 1.39） % to （2.44 ± 0.25） % （ P 〈 0.01 ）. Conclusion External non-restrictive polyester stent can significantly inhibit neointimal formation and medial thickening, thus may prevent late vein grafts restenosis.

关 键 词：内膜增生 中膜增厚 静脉桥 再狭窄 血管外支架 

分 类 号：R543.3[医药卫生—心血管疾病]