兔颈动脉修复联合牛心包补片成形术后再狭窄的效果研究  

Study on the effect of restenosis after carotid artery repair combined with bovine pericardial patch plasty in rabbits

作　　者：曾澄 冯远平 王良华 肖骏琦[2] 段青[2] 刘凤恩[2] Zeng Cheng;Feng Yuanping;Wang Lianghua;Xiao Junqi;Duan Qing;Liu Feng'en(Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases,Ministry of Education,Gannan Medical University,Ganzhou 341000,Jiangxi,China;Department of Vascular Surgery,the First Affiliated Hospital of Gannan Medical University,Ganzhou 341000,Jiangxi,China)

机构地区：[1]赣南医学院心脑血管疾病防治教育部重点实验室,江西赣州341000 [2]赣南医学院第一附属医院血管外科,江西赣州341000

出　　处：《血管与腔内血管外科杂志》2021年第7期787-792,798,共7页Journal of Vascular and Endovascular Surgery

基　　金：心脑血管疾病防治教育部重点实验室开放课题(XN201815)。

摘　　要：目的探讨兔颈动脉修复联合牛心包补片成形术后再狭窄的效果。方法按照兔颈动脉修复方法不同将15只兔子分为三组,每组5只。比较术后2周、4周、12周凝血指标和血细胞;术后2周、4周、12周超声观察颈动脉狭窄情况;观察术后12周三组动物苏木精-伊红染色法染色、Tunel凋亡检测、透射电镜和免疫组化结果。结果术后不同时间点三组凝血指标及血细胞比较,差异无统计学意义(P>0.05);术后不同时间点,对照组内膜增生严重,管腔狭窄;静脉补片组见假性动脉瘤形成,牛心包补片组缝合处均未见明显管腔狭窄、瘤样扩张、血栓形成等。补片周围均未见积液或脓肿。术后12周,对照组血管内膜显著增厚、结构致密,细胞严重纤维化,平滑肌细胞及纤维组织增生,静脉补片组与牛心包补片组内皮细胞排列整齐,纤维化程度较低;对照组与静脉补片组细胞凋亡较少,牛心包补片组细胞凋亡较多;对照组小细胞紧密分布于血管平滑肌细胞内,板层细胞排列紊乱和分层;静脉补片组中膜平滑肌细胞分布不规律、变性,间质增宽,中层胶原纤维显著增生;牛心包补片组中膜平滑肌细胞空泡变性,中层胶原纤维增生较少;对照组基质金属蛋白酶2、基质金属蛋白酶9表达量最高;牛心包补片组蛋白激酶Cα表达量最高。结论牛心包补片在颈动脉修复术中生物相容性较高,可有效防止术后再狭窄。Objective To explore the effect of bovine pericardial patch plasty on restenosis after carotid artery repair in rabbits by establishing a model of restenosis after carotid artery incision and suture in rabbits.Method According to different methods of carotid artery repair,15 rabbits were divided into three groups with 5 rabbits in each group.Blood coagulation indexes and blood cells were compared at 2,4 and 12 weeks after operation;the carotid stenosis was observed by ultrasound at 2,4 and 12 weeks after operation;the results of hematoxylin eosin staining,Tunel apoptosis,transmission electron microscope and immunohistochemistry were observed 12 weeks after operation.Result There was no significant difference in coagulation indexes and blood cells among the three groups at different time points after operation(P>0.05);at different time points after operation,intimal hyperplasia and lumen stenosis were serious in the control group;pseudoaneurysms were found in the venous patch group,and no obvious lumen stenosis,tumor like expansion and thrombosis were found in the suture of the bovine pericardial patch group.No effusion or abscess was found around the patch.At 12 weeks after operation,the vascular intima in the control group was significantly thickened,the structure was dense,the cells were seriously fibrotic,smooth muscle cells and fibrous tissue proliferated.The endothelial cells in the venous patch group and the bovine pericardial patch group were arranged orderly,and the degree of fibrosis was low;there was less apoptosis in the control group and intravenous patch group,and more apoptosis in the bovine pericardial patch group;in the control group,small cells were closely distributed in vascular smooth muscle cells,and lamellar cells were disordered and stratified;In the vein patch group,the distribution of smooth muscle cells in the middle membrane was irregular and denatured,the stroma widened,and the collagen fibers in the middle layer proliferated significantly;in the bovine pericardial patch group,the vacu

关 键 词：颈动脉狭窄 牛心包补片 基质金属蛋白酶 蛋白激酶 

分 类 号：R543[医药卫生—心血管疾病]