明胶联合VEGF内衬血管壁防止股动脉血管成形术后狭窄的实验研究.DOCVIP

临床医学论文-明胶联合VEGF内衬血管壁防止股动脉血管成形术后狭窄的实验研究 ???????????? 作者：蒋鸥 王志刚 乔正荣 时德 【摘要】目的：评价血管重建术后内衬明胶和内皮细胞生长因子（VEGF）受损血管壁对防止血管狭窄的效果。方法：建立兔股动脉再狭窄动物模型，实验组内衬浓度为30%的明胶及VEGF于损伤段动脉壁，分别于2周和4周采集标本，行图像分析及TUNEL原位杂交，比较实验组与对照组内膜面积（NEA）、内中膜面积比（NEA/MA）和平滑肌细胞凋亡率，电镜观察平滑肌细胞的增生及凋亡情况。结果：对照组较实验组新生内膜厚，而且细胞数也明显多。对照组NEA［2周及4周分别为（1.02±0.41）和（1.46±0.15）mm2］比实验组［分别为（0.57±0.15）和(1.18±0.36)mm2］大。NEA/MA对照组［2周及4周分别为（0.54±0.14）和(0.75±0.10)］也明显高于实验组［分别为(0.35±0.05)和（0.62±0.25）］。TUNEL阳性细胞率对照组2周为（13.6±2.4）%,4周为（15.1±2.1）%，治疗组分别为（18.2±5.8）%和（17.0±1.5）%。电镜观察发现对照组平滑肌细胞明显增生，细胞器发达，肌丝较多，而实验组见较多的凋亡小体有髓样结构形成。结论：提示明胶联合VEGF内衬血管成形术后的血管内壁对血管再狭窄有明显的抑制作用。 ??? 【关键词】血管狭窄?明胶?内皮细胞生长因子?内皮，血管?兔 ???? Investigation of vascular wall lined by Glutin and VEGF to prevent rabbit femoral arteries from restenosis after angioplasty ???? 【ABSTRACT】Objective:To evaluate the effectiveness that glutin and VEGF line the injured vasucler wall to prevent the drteries from restenosis.Methods:To build animal model of restenosis by balloon dilation in femoral artery.30 percent of glutin and VEGF were lined on injured vascular wall in the experiment,and samples were collected at 2 weeks and 4 weeks respectively.By imagine analysis system and DuTP nick end labeling,to compare neointimal area and neointimal area / media area of the control group with those of the experment group.The hyperplasia and the apoptosis of the vascular smooth muscle cells were obsenved by electron microscopy.Results:Intima of the control was thicker thanthe experiment group,and the control group had the more number of cells than the experiment group.From the morphology,neointimal area were reduced significantly in the experiment group(which was 0.67?.25mm2 at the 2 weeks and 1.18?.36 mm2 at the 4 weeks respectively)compared with the control group(which was 0.67?.25 mm2 at the 2 weeks and 1.18?.36 mm2 at the 4 weeks).Furthermore,NEA/MA of the experimetn group(which was 0.35?.05 at 2 weeks and 0.62?.25 at 4 weeks)was lower than that of the control(which was 0.54?.14 at 2 weeks