冠状动脉旁路移植术后影响静脉移植物内膜增生因素的实验研究  

Mechanism of intimal hyperplasia of venous grafts after coronary artery bypass grafting, an experimental study

作　　者：萧明第[1] 尤文俊[1] 袁忠祥[1] 徐根兴[1] 

机构地区：[1]上海市第一人民医院心血管外科,200080

出　　处：《中华医学杂志》2002年第22期1550-1552,共3页National Medical Journal of China

摘　　要：目的　研究静脉移植物内膜增生机理 ,为预防静脉移植物内膜增生寻找合理有效的途径。方法　 2 4只新西兰大白兔随机分为手术组和对照组。应用半定量方法分别于术后 2周、4周检测转化生长因子 β(TGF β)、胶原Ⅰ、胶原Ⅲ和血管紧张素Ⅱ受体 1(AT1R)mRNA表达水平。 结果　手术组各检测指标在各时点均明显高于对照组 (P <0 0 1)。术后 2周时 ,TGF β(4 0 5± 0 4 9vs 2 0 5±0 2 6 ) ;AT1R(18 2 3± 1 32vs 4 6 1± 0 5 3)、胶原Ⅰ (1 80± 0 17vs 0 90± 0 18)、胶原Ⅲ (7 0 5± 0 6 8vs2 80± 0 17)各基因表达水平最高。结论　TGF β、AT1R在内膜增生中可能发挥着重要作用。持续的动脉压力作用是导致TGF β、AT1R大量表达的主要因素 ,并由此导致胶原纤维的大量合成和沉积。Objective To study the mechanism of intimal hyperplasia after coronary artery bypass grafting (CABG) and to find an effective way for preventing intimal hyperplasia Methods Twenty four male New Zealand rabbits were randomly divided into two groups of 12 rabbits: operation group and sham operation (control) group The externaljugular vein was harvested and anastomosed end to side to the ipsilateral carotid artery in operation group or grafted in situ in the control group Six rabbits in each group were killed and their grafted veins were taken 2 weeks and 4 weeks after operation respectively The mRNA expressions of transforming growth factor β(TGF β), collagen Ⅰ, collagen Ⅲ, and angiotension 1 receptor (AT1R) were measured by RT PCR and electrophoresis Results The intimal hyperplasia was much more remarkable in the operation group than in the control group either 2 weeks or 4 weeks after operation The mRNA expressions of TGF β, AT1R, collagen Ⅰ, and collagen Ⅲ were significantly higher in the operation group than in the control group, especially 2 weeks after ( P <0 01) Four weeks after the operation, the expressions of TGF β, AT1R, collagen Ⅰ and collagen Ⅲ were 4 05±0 49 vs 2 05±0 26, 18 23±1 32 vs 4 61±0 53, 80±0 17 vs 0 90±0 18, and 7 05±0 68 vs 2 80±0 17 respectively (all P <0 05) Conclusion TGF β and AT1R may have an important role in the intimal hyperplasia of venous graft in CABG. Continuous arterial pressure may be the main factor of increased expression of TGF β and AT1R that cause the enormous synthesis and deposit of collagen

关 键 词：冠状动脉旁路移植术 静脉移植物 血管移植物闭塞 血管内膜增生 半定量方法 影响因素 

分 类 号：R654.2[医药卫生—外科学]