CO_2激光TMR与机械TMR管道内应用VEGF后的形态学对照观察  

Contrastive observation of histomorphology on the channels injected with VEGF after CO, laser TMR and drilling TMR

作　　者：张晓东[1] 王冬[1] 李若凡[1] 程效东[1] 刘克[1] 李姗姗[1] 曹承刚[1] 周梦玲[1] 王乃利[1] 寇印华[1] 何星华[1] 穆瑞民 徐达传[2] 

机构地区：[1]中国医学科学院基础医学研究所,中国协和医科大学解剖组胚学系,北京100005 [2]第一军医大学解剖学教研室,广东广州510515

出　　处：《中国临床解剖学杂志》2002年第2期139-142,共4页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金资助项目(39870385)

摘　　要：目的:对照观察CO2激光TMR与机械TMR管道内应用VEGF后心肌管道的热损伤、血管生成及纤维化等形态学变化,探讨TMR结合VEGF应用的方法.方法:采用成年家兔40只,均分A、B两组.分别行CO2激光TMR和机械TMR,同时在两组的管道内注射血管内皮细胞生长因子(VEGF).术后不同时间对照观察心肌管道的形态学变化.结果:激光TMR管道内存在着严重的热损伤,而机械TMR管道内无任何热损伤迹象;术后2周血管生成达高峰期,激光组新生血管密度/数量为(17.84±0.25)条/10×4倍,机械组为(24.20±0.98)条/10×4倍,P<0.01;术后6～8周新生血管密度/数量激光组为(8.93±0.24)条/10×4倍,机械组为(11.08±0.96)条/10×4倍, P<0.01;管道残迹纤维化的直径,激光组为(1.66±0.04)mm,机械组为(0.66±0.04)mm, P<0.001.结论:从TMR管道内新生血管密度/数量及管道残迹纤维化程度来看,机械TMR结合VEGF的应用方法明显优于C02激光TMR结合VEGF.Objective: To observe contrastively the effects of thermal injury, angiogenesis and fibrosis on the channels injected with VEGF after CO2 Laser TMR and drilling TMR, so that the better one of TMR methods combined with VEGF will be selected. Methods: Forty adult rabbits were divided into Laser group (group A, 20 cases) and drilling group (group B, 20 cases). The group A were treated with CO2 laser TMR and the group B with drilling TMR in vivo on the left ventricular wall of the rabbits. And then, VEGF was injected into the channels of each group. The histomorphometric structures in channels were observed contrastively at different period after TMR. Result: There was severe thermal injury around the laser channels, and no any indication of thermal injury on the walls of drilling TMR; The density and quantity of neovessels (NV) in channels come to a head after 2 weeks; The density analysis of NV within channels revealed a significant difference ( after 2 weeks, 17.84 ± 0.25 NV per 10 × 4 field in laser group versus 24.20 ± 0.98 NV per 10 × 4 field in drilling group, P < 0.01; after 6 - 8 weeks, 8.93 ± 0.24 NV per 10 × 4 field in laser group versus 11.08 ± 0.96 NV per 10×4 field in drilling group, P < 0.01) ; The diameter analysis of fibrosis showed a high significant difference (after 6 - 8 weeks, 1.66 ± 0.04mmin laser versus 0.66 ± 0.04mm in drilling, P < 0.001) .Conclusion: This study demonstrates that the drilling TMR combined with VEGF is better than the laser TMR combined with VEGF, and the former is suitable for clinical application.

关 键 词：激光 机械TMR 血管内皮细胞生长因子 血管生成 新生血管密度 纤维化 

分 类 号：R654.2[医药卫生—外科学]