不同损伤时期血管内膜的增殖和凝血酶的影响  

Vascular Proliferation in Different Injury Stage and the Effect of Thrombin on It in a Rat Model of Aortic Injury

作　　者：许俊堂[1] 唐朝枢[2] 张波[2] 刘乃奎[2] 侯琳[2] 王小红[2] 欧和生 李田昌[1] 胡大一[1] 翁心植[1] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院心脏中心,北京市100020 [2]北京医科大学

出　　处：《中国循环杂志》1999年第5期289-291,共3页Chinese Circulation Journal

基　　金：北京市科委科技新星计划

摘　　要：目的：探讨内皮拉伤后血管内膜增殖反应的动态变化，和凝血酶对损伤血管增殖反应的影响。　　方法：Ｆｏｇａｒｔｙ 导管拉伤大鼠主动脉，不同时期处死，病理观察血管内膜厚度，免疫组织化学观察增殖细胞核抗原在损伤血管的表达；并将离体的血管环在体外加入不同浓度的凝血酶［０ Ｕ／ｍ ｌ（对照组）、１ Ｕ／ｍ ｌ（１ Ｕ凝血酶组）和５ Ｕ／ｍ ｌ（５ Ｕ凝血酶组）］培养１２小时，测定单位重量血管环氚标记胸腺嘧啶脱氧核苷（３Ｈ－ＴｄＲ）的掺入量。　　结果：拉伤后血管内膜／中膜面积值于４～６周达到高峰，７～８周增厚的内膜几乎完全消退。增殖细胞核抗原的表达与血管内膜增殖反应基本一致。３Ｈ－ＴｄＲ掺入于术后３日和３ 周出现２个高峰。加入凝血酶１ Ｕ／ｍ ｌ或５ Ｕ／ｍ ｌ，３日的３Ｈ－ＴｄＲ掺入量增加，与０ 日比较有显著性差异Ｐ＜ ０．０５，４周后３Ｈ－ＴｄＲ掺入进入低反应期。　　结论：血管损伤后３ 日是细胞分裂最为活跃的时期，对凝血酶促增殖作用也最敏感，４周后为低反应期，因此及早有效抗凝对于控制血管增生和再狭窄有十分重要的意义。Objective: To study the dynamic changes of neointimal peoliferation,and the influence of thrombin on vascular proliferative response. Methods: The rat aorta were endothelium denuded by a fogarty catheter.The animals were killed in different postoperative phases for measuring the ratio of intima/media area, counting the expression of proliferative cell nuclear antigen in injured vascular intima by immunohistochemistry.Further,the excised aorta rings were incubated for 12 hours in 1640 medium supplemented with different content of thrombin(0 U/ml,1 U/ml and 5 U/ml). 3H TdR incorporation was determined. Results:Ratio of intima/media peaked at 4 6 weeks,and then regressed to normal by 7～8 weeks.The expression of proliferative cell nuclear antigen showed the similar trend to the proliferative reaction of vascular intima. 3H TdR incorporation showed two peak values at both 3 days and 3 weeks respectively.Along with the addition of thrombin, 3H TdR increased significantly at 3 days compared to 0 day.Four weeks latter,the incorporation of 3H TdR decreased in all three groups. Conclusion:Marked cell division occurred at the 3rd day after endothelial denudation,and during this period the reaction of cells to thrombin is most susceptiblle.And then decreases after 4 weeks in all three groups than control.So it very important that early and effective anticoagulation should be administered for avoiding intimal proliferation and formation of restenosis.

关 键 词：平滑肌细胞 凝血酶 增殖细胞核抗原 血管损伤 

分 类 号：R543.02[医药卫生—心血管疾病]