维拉帕米对家兔血管成形术后血浆纤维蛋白原和再狭窄的影响  

The Effects of Verapamil on Plasma Fibrinogen and Restenosis after Angioplasty in Rabbits

作　　者：王昭军[1] 黄从新[1] 孙广辉[2] 

机构地区：[1]武汉大学人民医院心内科,武汉430060 [2]镇江医学院附属医院心内科,江苏镇江212001

出　　处：《镇江医学院学报》2001年第3期294-297,共4页Journal of Zhenjiang Medical College

摘　　要：目的 :探讨血浆纤维蛋白原 (Fb)在血管成形术后的变化 ,研究维拉帕米 (Verapamil)对血管成形术后再狭窄的预防作用及可能机制。方法 :将 2 4只家兔随机分为假手术组、对照组 (单纯血管成形 )和维拉帕米干预组。对后两组家兔以球囊导管损伤腹主动脉内膜 ,喂养 4周后 ,对腹主动脉狭窄部位行血管成形术。其中干预组于术前及术后给予维拉帕米肌注 (剂量 0 .5mg·kg 1 ·d 1 )。分别于术前、术后 48小时、1周及 4周抽取静脉血测定三组家兔血浆Fb含量。血管成形术后 4周处死动物 ,对成形术部位动脉标本作病理形态学检查和免疫组化检查。结果 :血管成形术后血浆Fb含量明显增高 ,而干预组术后 48小时和 1周血浆Fb水平低于同期对照组 ,其差异有显著性 (分别P <0 .0 1和P <0 .0 5 )。病理形态学检查显示 :干预组管腔面积和内弹力板围绕面积均大于对照组 ,其差异均有高度显著性 (P均 <0 .0 1 ) ;而新生内膜面积和增殖细胞核抗原 (PCNA)增殖指数干预组均小于对照组 (P均 <0 .0 5 )。结论 :血管成形术后血浆Fb明显增高 ,而维拉帕米可抑制血浆Fb水平的升高 ,可抑制新生内膜增殖 ,促进代偿性血管扩张 ,从而可减轻血管成形术后再狭窄的程度。Objective:To study the change of plasma fibrinogen level after balloon angioplasty,and to research the effect of verapamil on arterial intimal hyperplasia and remodeling after angioplasty.Methods:Twenty eight rabbits were randomly divided into three groups: sham operation group,control group and verapamil therapy group. The endothilia of abdominal aorta were injured by a balloon. After 4 weeks, the rabbits of control group and verapamil therapy group were performed angioplasty. In verapamil group,verapamil was given to all eight rabbits(0.5mg·kg 1 ·day 1 )at 30 minutes before angioplasty and each day for 28 days after balloon angioplasty.The control group underwent the same balloon angioplasty but no medicine was administered. The sham operation group subjected to no angioplasty.The concentration of plasma fibrinogen was ditected at different periods of time before and after angioplasty. Animals were killed 4 weeks after balloon angioplasty, and the excised abdominal aorta segments were prepared for pathomorphological and immunohistochemistry analysis. Results: The level of plasma fibrinogen significantly increased after balloon angioplasty.One weeks and four weeks after angioplasty,the concentration was significantly lower in the verapamil group than that of the control group( P <0.01) at the same period of time.In the verapamil therapy group,the luminal cross sectional area was larger,the neointimal area was smaller,and the IEL was larger than that of control group respectively.All the above differences were significant ( P <0.01).The proliferation index of PCNA (proliferating cell nuclear antigen)was significantly higher in the control group than that of the verapamil therapy group( P <0.05).Conclusion:The level of plasma fibrinogen may be a risk factor or a predict factor of restenosis after angioplasty.Verapamil could reduce the concertration of plasma fibrinogen after angioplasty,inhibit new intimal proliferation,and prompt atery dilation.Therefore,verapamil could be applied to red

关 键 词：再狭窄 血管成形术 纤维蛋白原 维拉帕米 

分 类 号：R972[医药卫生—药品]