辛伐他汀联合左旋精氨酸对自体移植静脉保护作用的实验研究  

The experimental study of simvastatin and L-arginine to graft vein protection

作　　者：杨德勇 田茂良[2] 吴茂军[2] 吕方启[2] 

机构地区：[1]肥城矿业集团中心医院,山东肥城271608 [2]泰山医学院附属医院,山东泰安271000

出　　处：《泰山医学院学报》2010年第6期416-419,共4页Journal of Taishan Medical College

摘　　要：目的研究辛伐他汀联合左旋精氨酸对兔颈外静脉移植至股动脉后的保护作用,并探讨可能的机制。方法50只新西兰大白兔,随机分为辛伐他汀实验组、生理盐水对照组。术前3 d开始采用灌胃法给予辛伐他汀(10 mg/Kg溶于10 ml生理盐水),经耳缘静脉给予左旋精氨酸(100 mg/kg),对照组给与等量生理盐水,每天一次,直至术后取材。所有动物于术日建立自体静脉旁路移植模型:利用显微外科技术将颈外静脉端侧吻合于股动脉,于术后4周取血管桥标本,同时取0.5 cm移植静脉作为正常静脉参照。光镜下观察、测定移植静脉内膜中膜厚度变化。扫描电镜观察近吻合口处和中央部静脉桥的管腔狭窄程度(管腔增生面积与管腔面积比(S1/S2),统计学分析各组间差异。结果移植4周后,各组静脉均有内膜及中膜较正常颈静脉明显增厚表现,辛伐他汀组内膜及中膜增厚较对照组轻。两组静脉桥的管腔狭窄程度进行比较存在明显差异。结论(1)兔颈外静脉移植至股动脉后内膜及中膜增厚。(2)辛伐他汀联合左旋精氨酸能抑制动脉化静脉内膜及中膜增厚,有减轻桥静脉狭窄的作用。Objective：To study the protective effects of simvastatin and L-arginine on the external jugular vein after being transplanted into femoral artery and explore its possible mechanism.Methods： Autogenous vein grafts model was established in 50 rabbits.Interposition jugular vein were transplaced into carotid artery of the rabbits by microsurgical technique.Animals received either simvastatin（10 mg/kg/day） and L-arginine（100 mg/kg/day） were injeted into the ear veins.The control group given normal saline by oral gavage 72 hours before and then daily after surgery.Interposition jugular vein were transplanted into femoral arteries of the rabbits by microsurgical technique.grafting veins weresampled after 4 weeks,At the same time take normal vein did not refer to the opposite side of vein graft.The veins were cut into 2 segments.One was for endothelial integrity grading by SEM examination.The other was interposed between contralateral common carotid arteries.The vein grafts were harvested at 2 weeks after grafting.Neintimal square-to-luminal square ratio（S1/S2）was measured with a computerized image analysis system.Results： The stenosis of grafted veins：4 weeks later,the jugular veins intima/media membrane of all the operative groups were significantly thicker than The normal control group.There were significant differences between every two group（P0.05）.Conclusion：（1）The intima/media membrane of hare＇s external jugular vein has thickened after grafting.（2） Simvastatin can lessen the thickness of arterialized vein？s intima/media membrane and lighten the stenosis of the bridging vein.

关 键 词：内膜增生 细胞增殖 静脉移植 辛伐他汀 左旋精氨酸 

分 类 号：R654.3[医药卫生—外科学]