血流切应力的增加而非缺血可能是启动侧支血管生长发育的主要因素  

Increase in shear stress,not ischemia,likely is the key factor for collateral vessel growth

作　　者：谢应桂[1,2] 童建斌[3] 伍校琼[3] 蔡维君[3] 吴松[4] 

机构地区：[1]湘南学院基础医学部人体解剖学教研室 [2]中南大学湘雅医学院人体解剖学与神经生物学系,湖南长沙410013 [3]中南大学湘雅医学院人体解剖学与神经生物学系 [4]中南大学湘雅三医院骨科

出　　处：《中国现代医学杂志》2007年第17期2099-2101,2106,共4页China Journal of Modern Medicine

基　　金：湖南省教育厅科研基金(06C781)

摘　　要：目的探讨血流切应力的变化和缺血对侧支血管生长的影响。方法成年大白兔7只,单侧股动脉结扎后,将结扎远侧端和伴行股静脉吻合,制成动静脉短路诱导侧支血管生长模型。用共聚焦显微镜结合免疫荧光术研究胫骨前、后肌和腓肠肌内小动脉及毛细血管的细胞增殖和密度变化。结果在非手术侧上述肌肉的小血管和毛细血管没有细胞增殖,肌肉内细胞增殖非常低。在动静脉吻合侧,小动脉血管平滑肌细胞没有细胞增殖,偶可见管腔内或内皮细胞层有Ki67阳性细胞。但胫骨前肌、胫骨后肌和腓肠肌内毛细血管内皮细胞增殖十分活跃,细胞核Ki67的阳性率为(242±12)、(239±17)和(260±11)个/mm2。毛细血管的密度显著增加,在胫骨前肌、胫骨后肌和腓肠肌分别为每平方毫米(805±40)、(784±34)和(820±29)根,分别是对应正常肌组织毛细血管密度的2.00、1.95和1.88倍。结论血流动力学的变化是启动侧支血管生长的驱动因素,而缺血不能诱导侧支血管生长。[Objective] To investigate the effect of haemodynamic changes and ischemia oncollateral vessel growth. [Methods] an arteriovenous shunt model of rabbit hind limb was created unilaterally between the distal stump of one of the bilaterally occluded femoral arteries with the accompanying vein. Cell proliferation and capillary density in the tibialis anterior, tibialis posterior and gastrocnemius were studied by confocal immunofluorescence. [Results] In no operative side the small arteries and capillaries in the tibialis anterior, tibialis posterior and gastroenemius showed no signs of proliferation; in shunt side, the cell proliferation in smooth muscle cells in small arteries was also negative, although occasionally few ki67 positive cells were found in the lumen or adjacent to the endothelium. However, cell proliferation on capillaries was very active. The proliferation rates （number/mm^2） were （242±12）, （239±17） and （260±11） in the tibialis anterior, tibialis posterior and gastrocnemius, repectively. The capillary densities （number/mm^2） of above muscles were （805±40）, （784±34）and （820±29）,repectively. They were 2 times, 1.95 times and 1.88 times higher over that in corresponding normal muscle tissue. [Conclusions] our data for the first time provides direct evidence that collateral vessel growth is initiated by increased shear stress, rather than ischemia.

关 键 词：侧支血管 毛细血管 切应力 缺血 

分 类 号：R331[医药卫生—人体生理学]