血管球囊损伤后内皮增生及血管重构对再狭窄的影响  

Effect of Proliferation and Artery Remodeling on,Restenosis after Balloon Angioplasty

作　　者：戴秋艳[1] 郑道声[1] 陆惠华[1] 方宁远[1] 盖保康[1] 刘建平[1] 

机构地区：[1]上海第二医科大学附属仁济医院心内科,200001

出　　处：《上海第二医科大学学报》1998年第4期289-292,共4页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：采用球囊拉伤血管内膜加高脂饲养的方法建立兔髂动脉粥样硬化模型,4～6周后行双侧髂动脉球囊扩张术,分别于术后1、3、7、14、28d 取病变血管段病理标本,应用病理学方法及计算机图像分析,观察术后不同时间点的血管增生及重构情况。结果表明:1.损伤后1d 即出现血管增粗(外弹力膜内横截面积扩大)并持续至术后28d。2.损伤后管腔面积前3d 增大,7d 后开始缩小。3.损伤后内膜增生,从第7d 为高峰;中膜增生开始于第3d,第7～28d 持续峰值,结果提示:球囊损伤后不仅存在血管壁增生,血管慢性回缩及重构亦是构成再狭窄的重要原因。In this study,a reproducible rabbit model of atherosclerosis was established with cholesterol feeding after iliac artery injury made with an inflated balloon catheter.Balloon angioplasty were made in the model animals.1,3,7,14,28 days.after operation,lilac arteries were fixed in situ at physiological pressure.Pathologic change of vessel remodeling were observed by microscopy and computer image analysis technology.The result showed that (1) 1 day after artery injury,artery size(cross-sectional area bounded by the EEL area) increased and maintained for 28 days.(20 Lumen area increased at 1 to 3 days after injury and declined to the size of control group at 7 days.(3) Intimal hyperplasia was highest at 7 days,medial thickening(major SMC) began at 3 days, maintained at peak rate from 7 to 28 days.These results suggest that neointimal proliferation is not the only reason of restenosis,chronic arterial remodeling plays a major role in the final lumen area size.Understanding and controlling the remodeling process rather than concentrating solely on intimal hyperplasia may yield better results after balloon angioplasty in the future.

关 键 词：球囊血管成形术 血管重构 内膜增生 血管再狭窄 

分 类 号：R654.2[医药卫生—外科学]