手术缝线携载反义基因预防血管吻合口内膜增生的实验研究  

Prevention of vascular anastomotic site intimal hyperplasia by suture carrying antisense oligodeoxynucleotide

作　　者：曲乐丰[1] 景在平[1] 曹贵松[1] 仲剑平[1] 

机构地区：[1]第二军医大学附属长海医院血管外科,上海200433

出　　处：《中华普通外科杂志》2002年第1期36-37,共2页Chinese Journal of General Surgery

基　　金：国家自然科学基金资助项目 ( 396 70 70 7)

摘　　要：目的探讨预防血管吻合口内膜增生的新方法 ,了解手术缝线携载反义基因对吻合口内膜增生的影响。方法用分别浸泡过反义、正义及错配c myc基因溶液的保护薇乔缝线行兔颈外静脉间置于同侧颈总动脉的血管吻合。实验动物 2 4只随机分为对照组、反义组、正义组和错配组 ,每组 6只。 4周后血管造影观察吻合口通畅情况 ,同时取材制片显微镜下观察其内膜增生情况 ,计算机图像分析测量其内膜、中膜厚度及两者比值 ;内膜、中膜面积及两者比值。结果所有吻合口通畅 ,未见闭塞、扩张或动脉瘤。反义组的内膜厚度、内膜 /中膜厚度比值及内膜面积、内膜 /中膜面积比值较其他组均低 (P <0 0 5 ) ;其他 3组间比较差异均无显著意义 (P >0 0 5 ) ;各组间的中膜厚度及中膜面积间差异无显著意义 (P >0 0 5 )。结论用浸泡过反义c myc溶液的保护薇乔缝线进行血管吻合 。Objective To develop a new way to prevent vascular anastomotic intimal hyperplasia, we applied surgical suture soaked in c-myc antisense oligodeoxynucleotide solution to perform vascular anastomosis in rabbits. Methods8/0 sutures (coated Vicryl) soaked in antisense, sense and mismatched c-myc oligomer solution respectively were applied to accomplish vascular anastomoses in rabbits with interposition of external jugular veins between common carotid arteries. Twenty-four animals were randomly divided into four groups: control group, antisense group, sense group and mismatched group. Four weeks later, angiography was made to scrutinize the patency of anastomosis and specimens were harvested for microscopy, the image was digitalized by computer video analysis system, the intimal thickness and area, medial thickness and area and their ratios were calculated and analyzed statistically among groups. Resultsall the anastomoses were normal and patent. The intimal thickness, intimal/medial ratio and intimal area, intimal/medial area ratio in antisense group were significantly lower than those in other groups(P<0.05). ConclusionsThe suture carrying c-myc antisense oligodeoxynucleotide suppresses the intimal hyperplasia in vascular anastomotic site effectively.

关 键 词：手术后并发症 反义DNA 内膜增生 缝线 血管吻合口 

分 类 号：R654.4[医药卫生—外科学] R654.3[医药卫生—临床医学]