血管外膜和胶原分布对内膜增生及血管重塑的影响  

Effects of Vascular Adventitia and Collagen Distribution on Intimal Hyperplasia and Vascular Remodeling

作　　者：邱志兵[1] 陈鑫[1] 万松[2] 

机构地区：[1]南京医科大学附属南京第一医院南京市心血管病研究所心胸外科,南京210006 [2]香港中文大学威尔斯亲王医院心胸外科

出　　处：《中国胸心血管外科临床杂志》2008年第4期272-276,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：香港研究基金会特别基金资助(CUHK4310/99M)~~

摘　　要：目的动态观察移植静脉再狭窄动物模型中血管外膜和胶原的变化,以评价血管外膜和胶原对内膜增生和血管重塑的影响。方法长白猪18只,建立猪移植静脉再狭窄模型,术后随机分为3组,术后7d组,术后30d组和术后45d组,每组6只;未移植前的大隐静脉作为对照组。采用HE和Masson染色,观察各组血管成分结构、外膜细胞密度、增生指数和胶原的动态变化。结果术后7d组新生内膜形成并增厚,外膜厚度和细胞密度增大,外膜和新生内膜中胶原增多,血管腔面积减少,但与对照组比较差异无统计学意义(F=2.03,P=0.091),而剩余狭窄率逐渐增大(F=5.16,P=0.033),重塑指数和外弹力板围绕面积(EELA)稍有增大。术后30d组新生内膜明显增厚,外膜厚度和细胞密度达最大,新生内膜中含大量胶原,呈进行性增多趋势,外膜中胶原含量达最大,管腔面积和内膜弹力板围绕面积(IELA)明显减小,剩余狭窄率较对照组明显增大(F=6.63,P=0.018),重塑指数和EELA较术后7d组明显减小。术后45d组新生内膜增厚达最大,外膜细胞密度较术后30d组减小(F=6.91,P=0.015),新生内膜中胶原含量达最大,外膜中胶原含量较术后30d组减少,并见局部纤维化;管腔面积、重塑指数、IELA和EELA达最小,剩余狭窄率达最大。结论移植血管再狭窄是内膜增生和血管重塑共同作用的结果。血管外膜的增厚、纤维化及胶原的重排对内膜增生和血管重塑起着重要作用,参与并促进了移植血管再狭窄的发生过程。Objective To investigate the dynamic changes of vascular adventitia and collagen distribution in the vein graft restenosis model, and evaluate the effects of adventitia and collagen distribution on intimal hyperplasia and vascular remodeling. Methods The pig autogenous vein grafts restenosis model from 18 long-white pigs were created. 18 pigs were divided into 3 groups： 7th day group after operation, 30th day group after operation and 45th day group after operation according to animals harvested after surgery. The preoperative graft was as control group. According to HE and Masson staining slices, the vascular thickness, cell density, collagen distribution and vascular remodeling were investigated by histomorphometrical approach. Results In 7th day group after operation, the neointima formed and continuously thickened. The thickness and cell density of adventitia increased gradually, and the collagen of adventitia and neointima gradually increased, the luminal area gradually decreased after operation, but have no significant difference with control group （F=2. 03, P=0. 091 ）. The residual restenosis rate increased inversely（F=5.16,P=0. 033）. Remodeling index and external elastic lamina area （EELA） slightly increased. In 30th day group after operation, the neointima thickened significantly, the thickness and cell density of adventitia reached the peak. There were a significant increase in the collagen of neointima, and the collagen of adventitia reached maximum. The luminal area and inter elastic lamina area（IELA） reduced distinctly as compared with 7th day group, the residual restenosis rate increased significantly （F=6. 63, P = 0. 018）, but remodeling index and EELA decreased distinctly as compared with 7th day group after operation. In 45th day group after operation, the thickness of neointima reached maximum, but the cell density of adventitia reduced distinctly compared with 30th day group after operation （F = 6. 91, P = 0. 015）. The collagen of neointima reached maximum, but the col

关 键 词：血管外膜 胶原 内膜增生 血管重塑 再狭窄 

分 类 号：R543.5[医药卫生—心血管疾病]