血管外支架预防猪大隐静脉桥再狭窄的实验研究  

Experimental study of external stents prevent porcine saphenous vein grafts restenosis

作　　者：郑家豪[1] 潘文标[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,200001

出　　处：《中华胸心血管外科杂志》2006年第6期415-417,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：上海市教委资助(03BK21);上海市浦东新区科技局资助(Pkj2002-60)

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取出桥血管，组织学和免疫组化检测。结果静脉桥血管内膜增生对照组（0．4269±0．0794）mm，实验组（0．1371±0．0390）mm（P〈0．01）；中膜增生对照组（0．4601±0．0628）mm，实验组（0．2590±0．0178）mm（P〈0．01）；对照组内膜面积是实验组的2．5倍，中膜面积是实验组的近2倍；实验组内膜及中膜内侧区域PCNA、PDGF阳性细胞显著减少，PCNA从（13．2±2．17）％减少至（2．34±0．68）％（P〈0．01），PDGF从（13．10±1．39）％减少至（2．44±0．25）％（P〈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增生，可能预防大隐静脉桥的再狭窄。Objective To evaluate the effect of external stents on preventing vein graft neointima formation and medial thickening with non-restrictive macro-porons polyester stent around porcine vein grafts, Methods Studies were performed in ＂white race＂ pigs （n = 10 ） with body weight 20 - 25 kg. All the animals underwent bilateral saphenous vein into carotid artery interposition grafting. In each animal, a macroporons stent was placed around a graft on one side and an unstented graft on the opposite side as control. The polyester stont was long enough to cover both anastomoses complexly. The size of the stent allowed unrestricted expansion of the graft in initial response to arterial pressure. After 28 days of surgery, 10 animals were taken to remove grafts. Graft wall dimensions, PDGF expression and cell proliferation using proliferating cell nuclear antigen （PCNA） were measured on histological sections by immunohistochemistry. Results Stonts significantly reduced neointimal thickening from （0.4269 ± 0. 0794 ）mm to （0. 1371 ± 0. 039） mm （n = 10, P 〈 0.01 ）and medial thickening from （0.4601 ± 0.0628） mm to （0.2590 ± 0.0178） mm （n =10, P 〈 0.01 ）. Stents significantly reduced the percentage of cells expressing PDGF and PCNA. Media： intimal PCNA index was reduced from （ 13.20 ± 2.17）% to （2.34±0.68）%（n= 10, P〈0.01）, PDGF index was reduced from （13.10±1.39）% to （2.44±0.25）%（n= 10, P 〈 0.01 ）. Conclusion External non-restrictive polyester stent can significantly inhibit neointimal formation and medial thickening, may prevent late vein grafts restenosis.

关 键 词：冠状动脉分流术 静脉 移植物闭塞 血管 支架 

分 类 号：R654.3[医药卫生—外科学]