维拉帕米对实验兔血管成形术后内膜增殖和血管重塑的影响  

The effects of verapamil on neointimal proliferation and vascular remodeling after angioplasty

作　　者：王昭军[1] 孙广辉[1] 

机构地区：[1]镇江医学院附属医院心内科,江苏镇江212001

出　　处：《临床心血管病杂志》2002年第8期384-386,I001,共4页Journal of Clinical Cardiology

摘　　要：目的 :探讨维拉帕米对血管成形术后新生内膜增殖和血管重塑的影响及其机制。方法 :家兔 2 4只 ,随机分为假手术组、对照组和干预组。以球囊导管损伤家兔腹主动脉内膜 ,喂养 4周后 ,对后两组家兔腹主动脉狭窄部位行球囊成形术。其中对照组仅行血管成形术 ,干预组于术前 30min及术后每天给予维拉帕米肌注 [剂量 0 .5mg/ (kg·d) ]。分别于术前 ,术后 4 8h、1周及 4周采静脉血测定 3组家兔血清一氧化氮 (NO)含量。术后 4周处死动物 ,对成形术部位腹主动脉标本作病理形态学检查和免疫组化检查 ,并利用计算机图像分析系统分别测量血管管腔面积、新生内膜面积、内弹力板围绕面积、内膜 /中膜面积 ,计算增殖细胞核抗原 (PCNA)增殖指数(PI)。结果 :血管成形术后血清NO浓度降低 ,但术后 1周和 4周维拉帕米干预组血清NO浓度高于对照组同期水平 ,差异有非常显著性意义 (均 P <0 .0 1)。病理形态学检查示对照组和干预组管腔面积分别为 (6 .4 18±0 .6 5 8)和 (13.4 82± 1.2 0 5 )× 10 4μm2 ;内弹力板围绕面积分别为 (19.719± 1.0 87)和 (2 4 .32 6± 1.4 2 7)× 10 4μm2 。上述指标两组之间比较差异均有非常显著性意义 (均P <0 .0 1)。对照组和干预组新生内膜面积分别为 (13.176± 0 .6 34)和 (10 .195± 0 .Objective: To study the effects of verapamil on arterial intimal hyperplasia and remodeling after angioplasty. Methods: Twenty four rabbits were randomly divided into three groups: sham operation group, control group and verapamil therapy group. The endothelia of abdominal aorta were injured by a balloon. After 4 weeks, the rabbits of control group and verapamil therapy group received angioplasty. In verapamil therapy group, verapamil was given to all eight rabbits ( 0.5 mg/(kg·d) at 30 minutes before and after balloon angioplasty for 28 days. The control group, 8 rabbits, underwent the same balloon angioplasty but no medicine were administered. The sham operation group subjected to no angioplasty. The concentration of serum nitric oxide (No) was ditected 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 concentration of serum NO decreased after balloon angioplasty (P< 0.05 ). One week and four weeks after angioplasty, the concentration of serum NO was higher in verapamil group than that of control group (P< 0.01 ,respectively). In control group and verapamil therapy group, the luminal cross sectional areas were ( 6.418 ± 0.658 ) and ( 13.482 ± 1.205 )×10 4 μm 2, respectively, the intimal elastic lamina were ( 19.719 ± 1.087 ) and ( 24.326 ± 1.427 )×10 4μm 2, respectively. Both of the above differences were significant (P< 0.01 ). The neointimal area in control group and verapamil therapy group was ( 13.176 ± 0.634 ) and ( 10.195 ± 0.513 )×10 4μm 2, respectively (P< 0.05 ). The proliferation index of PCNA (proliferating cell nuclear antigen) was significantly higher in control group than that of verapamil therapy group (P< 0.05 ). Conclusion: Verapamil can increase the concentration of serum NO after angioplasty, inhibit new intimal proliferation, prompt atery

关 键 词：血管成形术 气囊 内膜增殖 血管重塑 维拉帕米 

分 类 号：R654.3[医药卫生—外科学]