α-氰基丙烯酸酯血管外支架对兔动静脉内瘘近吻合口静脉内膜增生的影响  

Effect ofα-cyanoacrylate extravascular stent on venous intimal hyperplasia in the juxta-anastomotic veins of arteriovenous fistula in rabbits

作　　者：刘贤华 焦自钊 付海霞 安传国 张孝福 王洪娟 LIU Xian-hua;JIAO Zi-zhao;FU Hai-xia;AN Chuan-guo;ZHANG Xiao-fu;WANG Hong-juan(Department of Vascular Surgery,the People’s Hospital of Rizhao City Affiliated to Jining Medical College,Rizhao 276826,China;Department of Blood Purification,the People’s Hospital of Rizhao City Affiliated to Jining Medical College,Rizhao 276826,China)

机构地区：[1]济宁医学院附属日照市人民医院血管外科,日照276826 [2]济宁医学院附属日照市人民医院血液净化科,日照276826

出　　处：《中国血液净化》2021年第8期547-551,共5页Chinese Journal of Blood Purification

基　　金：济宁医学院教师科研扶持基金项目(JYFC2019FKJ221);日照市科技研发专项基金(KJYF2019289)。

摘　　要：目的观察α-氰基丙烯酸酯(α-cyanoacrylate,α-CA)血管外支架对兔动静脉内瘘(arteriovenous fistula,AVF)近吻合口静脉内膜增生的影响。方法取20只成年雄性家兔,随机分为2组,每组10只。①对照组:颈总动脉、颈总静脉端端吻合建立AVF。②α-CA组:AVF建立后,近吻合口静脉外周表面应用α-CA涂层建立血管外支架。分别于手术中、手术后1月,彩色多普勒超声检测近吻合口静脉的内径及收缩期峰值血流速度,并于手术后1个月取AVF近吻合口静脉作如下检测:HE染色测量其内膜厚度、内中膜厚度比值,免疫组化法检测其内膜增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)、α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)的表达。结果AVF手术后1个月,彩色多普勒超声检测显示对照组AVF近吻合口静脉内径[(3.50±0.30)mm]较α-CA组[(3.22±0.23)mm]明显增加(t=2.326,P=0.032);对照组AVF近吻合口静脉收缩期峰值血流速度[(512.0±83.6)mm/s]较α-CA组[(668.6±64.1)mm/s]明显降低(t=4,701,P<0.001)。HE染色显示对照组AVF近吻合口静脉内膜厚度[(35.3±6.1)]μm较α-CA组[(24.8±5.6)μm]明显增加(t=3.987,P=0.001);免疫组化法显示对照组AVF近吻合口静脉内膜PCNA、α-SMA的阳性率[(20.5±3.9)%、(25.9±4.7)%]明显高于α-CA组[(14.2±3.1)%、(16.5±3.7)%],组间比较,差异均有统计学意义(t值分别为3.993、4.948,P值分别为0.001、<0.001)。结论α-氰基丙烯酸酯血管外支架能够减轻家兔颈总动静脉内瘘近吻合口静脉内膜增生。Objective To observe the effect of extravascular stent coated withα-cyanoacrylate(α-CA)on venous intimal hyperplasia in juxta-anastomotic veins of arteriovenous fistula(AVF)in rabbits.Method Twenty adult male rabbits were randomly divided into control group(n=10)andα-CA group(n=10).AVF was created by end-to-end anastomosis of common carotid artery and common jugular vein in animals of both groups.In theα-CA group,extravascular stent coated withα-CA was applied to the outer surface of juxtaanastomotic vein.Color Doppler ultrasonography was used to examine the diameter and peak systolic flow velocity of the juxta-anastomotic vein immediately after the operation and after the operation for one month.The juxta-anastomotic vein was taken after the operation for one month,the intimal thickness and the ratio of intima/media thickness were measured after hematoxylin-eosin(HE)staining,and the expression of proliferating cell nuclear antigen(PCNA)andα-smooth muscle actin(α-SMA)were detected by immunohistochemistry.Result After the operation for one month,color Doppler ultrasonography showed that the diameter of juxtaanastomotic vein of AVF was 3.50±0.30 mm in the control group higher than the diameter of 3.22±0.23 mm in theα-CA group(t=2.326,P=0.032);the peak systolic flow velocity in juxta-anastomotic vein of AVF was 512.0±83.6mm/s in the control group,lower than the velocity of 668.6±64.1mm/s in theα-CA group(t=4,701,P<0.001).H-E staining of the intimal in the juxta-anastomotic vein showed that the intimal thickness was 35.3±6.1μm in the control group,higher than that of 24.8±5.6μm in theα-CA group(t=3.987,P=0.001).Immunohistochemistry of the intimal in the juxta-anastomotic vein showed that the positive expression rates of PCNA andα-SMA in the in intimal cells were 20.5±3.9%and 25.9±4.7%respectively in the control group,higher than those of 14.2±3.1%and 16.5±3.7%respectively in theα-CA group(t=3.993 and 4.948 respectively,P=0.001 and<0.001 respectively).Conclusion Extravascular stent coated with�

关 键 词：动静脉内瘘 内膜增生 Α-氰基丙烯酸酯 血管外支架 

分 类 号：R318.16[医药卫生—生物医学工程]