血管成形术后血管重塑动态变化的实验研究  

Time course of vascular remodeling after angioplasty

作　　者：贾新未[1,2] 霍勇[1,2] 朱国英 

机构地区：[1]河北职工医学院附属医院心内科 [2]北京医科大学第一医院心内科

出　　处：《中华心血管病杂志》1997年第2期132-134,共3页Chinese Journal of Cardiology

基　　金：卫生部资金

摘　　要：对３７只家兔髂动脉粥样硬化模型的６５支病变血管行球囊扩张术，观察血管重塑的动态变化。分别于术后即刻（Ｇ０ｄ组，ｎ＝２０）、３天（Ｇ３ｄ组，ｎ＝１１）、２周（Ｇ２ｗ组，ｎ＝１１）、４周（Ｇ４ｗ组，ｎ＝２３）行血管造影后处死动物，取扩张段血管做组织形态测量分析。数据经ｔ检验、卡方及秩和检验。结果发现，Ｇ３ｄ组与Ｇ０ｄ组比较，内膜面积不变，但腔面积显著减小（Ｐ＜０．０５），内弹力板围绕面积亦有缩小。Ｇ２ｗ组与Ｇ３ｄ组比较，内膜显著增生，腔面积缩小（Ｐ＜０．０５），内弹力板向外扩大。Ｇ４ｗ组与Ｇ２ｗ组比较发现，内膜面积显著缩小（Ｐ＜０．０５），内弹力板明显回缩（Ｐ＜０．０５），腔面积进一步缩小。中膜面积在整个过程中无显著变化。结果表明，血管成形术后血管重塑的动态变化严重影响血管腔的大小。提示防治再狭窄需要控制血管重塑及内膜增生的联合策略。Using the atherosclerotic iliac artery model of 37 rabbits with 65 lesions, we quantitively assessed the time course of vascular remodeling. After angioplasty, 12 rabbits were killed immediately (G0d, n =20), 6 rabbits were killed on day 3 (G3d, n =11), 6 rabbits were killed on day 14 (G2w, n =11). The rest 13 were killed on day 28 (G4w, n =23). Vascular pressure was perfused (100 mmHg, 15 mins) and excised for histomorphometrical study. Paried t test and One Way ANOVA were used for statistical analysis. Compared with G0d, the lumen area in G3d decreased by 19.6% ( P <0.05), whereas the decrease of IEL area in G3d was not statistically significant, and the intimal area was the same. From day 3 to day 14, the intimal area increased and IEL took compensatory enlargement, lumen area decreased only by 0.18 mm 2. From day 14 to day 28, the intimal area reduced and IEL shrank significantly, lumen area further decreased. Medial area did not change during this period. In conclusion, vascular remodeling after angioplasty affected the lumen area heavily. To reduce restenosis after transluminal angioplasty, the combined strategies of controlling both intimal hyperplasia and vascular remodeling were required.

关 键 词：动脉粥样硬化 血管成形术 经皮 

分 类 号：R654.305[医药卫生—外科学]