药物涂层球囊治疗对冠状动脉再狭窄老年患者靶血管内膜反应、靶病变血运重建的影响

目的 探讨药物涂层球囊治疗冠状动脉再狭窄老年患者对靶血管内膜反应、靶病变血运重建的影响及安全性。方法 选取2017年11月—2019年1月锦州医科大学附属第一医院收治的冠状动脉再狭窄老年患者198例，根据随机数字表法分为研究组与对照组，每组99例。对照组采取切割球囊治疗，研究组采取药物涂层球囊治疗。对两组治疗前和治疗3个月、6个月后靶血管内膜反应、心功能、中国心血管病人生活质量评定问卷（CCQQ）评分、不良心血管事件发生率、管腔再狭窄率及靶病变血运重建发生率进行比较。结果 两组最小腔径、最小管腔面积比较，差异有统计学意义（P <0.05），两组左室射血分数、NT-proBNP及每搏输出量比较，差异有统计学意义（P <0.05），两组不良心血管事件总发生率比较，差异无统计学意义（P >0.05），对照组靶病变血运重建发生率高于研究组（P <0.05）。两组CCQQ评分比较，差异有统计学意义（P <0.05）。结论 药物涂层球囊治疗冠状动脉再狭窄老年患者可明显改善靶血管内膜反应，降低靶病变血运重建发生率，促进心功能恢复，可以改善生活质量。     

血管球囊损伤后内膜增生及血管重塑对再狭窄的影响

目的:探讨在血管再狭窄形成过程中内膜增生及血管重塑的作用.方法:采用大鼠颈动脉球囊损伤后血管再狭窄的动物模型,经形态学观察及计算机图像分析,观测术后不同时间点血管壁各成分的变化. 结果:血管损伤后3 d血管内腔面可见增殖的血管平滑肌细胞,损伤后7 d新生内膜形成并继续增厚,损伤后28 d新生内膜厚度及面积达最大,损伤后35 d较损伤后28 d缩小(P<0.01). 损伤后各时间点中膜厚度无明显变化,但损伤后35 d的中膜面积较损伤后28 d及对照未损伤侧缩小(P<0.05). 管腔面积于损伤后前3 d略增大,损伤后7 d出现管腔面积减少,至损伤后28~35 d管腔面积明显小于对照未损伤侧(P<0.01). 外弹力膜内横截面积在损伤后3~7 d略增大,损伤后14 d最大,损伤后35 d较损伤后28 d及对照未损伤侧明显缩小(P<0.01). 结论:内膜增生与血管重塑是再狭窄形成的主要病理机制,血管再狭窄的形成是内膜增生与血管重塑的平衡所决定的,两者共同导致管腔狭窄.     

全反式维甲酸对大鼠腹主动脉球囊损伤后血管重塑的影响

目的:研究全反式维甲酸(ATRA)对球囊损伤大鼠腹主动脉血管重塑的影响。方法:制作球囊损伤的大鼠腹主动脉剥脱模型,12只Wistar大鼠随机分为①对照组:6只腹腔内注射intralipid(1mL/d),②ATRA组:6只腹腔内注射溶解于intralipid的ATRA(4mg·kg~(-1)·d~(-1)).球囊损伤14d后,损伤区域的血管段用10％福尔马林固定,然后染色,进行形态学分析。结果:ATRA明显减小新生内膜面积(IA),增加管腔面积(LA)和外弹力膜包绕面积(EEL)。结论:ATRA具有促进有益的血管重塑的作用。     

^32P局部照射预防猪冠状动脉再狭窄研究

目的：评价^32P灌注球囊预防再狭窄的有效性、可行性和安全性。方法：对猪冠状动脉左前降支行过度球囊扩张术后,治疗组以^32P作血管内照射,对照组作假照射。术后35d收获目标血管、检测血管形态、细胞增殖百分比等。结果：治疗组血管腔面积较对照组明显增大（P＜0．01）,新生内膜面积、血管狭窄程度和各层PCNA阳性细胞明显减小（P均＜0．01）。结论：^31P灌注球囊照射预防冠状动脉再狭窄有效、安全而且可行。     

芦荟大黄素对兔髂动脉损伤后内膜增生及血管重塑反应的在体研究

目的探讨芦荟大黄素对兔髂动脉损伤后内膜增生及血管重塑反应的影响。方法将14只纯种日本大耳白兔随机分为髂动脉球囊损伤用药组和非用药组,于手术前后分别给予芦荟大黄素〔40mg/(kg·d)×7d〕或等体积的生理盐水肌肉注射。14d后,取出左右髂总动脉,用计算机图像分析仪对其切片进行形态测量分析。结果用药组与未用药组比较,最大内膜厚度均值稍低〔(0.043±0.013)mm比(0.048±0.015)mm,P>0.05〕;新生内膜面积减小〔(0.025±0.005)mm2比(0.035±0.008)mm2,P<0.05〕;管腔面积增大〔(0.098±0.011)mm2比(0.08±0.013)mm2,P<0.05〕;管腔面积和内膜面积及外弹力膜面积之比升高(用药组为0.793±0.036、0.617±0.054;非用药组为0.699±0.063、0.538±0.057,P<0.05)。用药组与未用药组比较,外弹力膜面积稍增大〔(0.160±0.010)mm2比(0.152±0.01)mm2,P<0.2〕,但与未受损伤的正常髂动脉外弹力膜面积〔(0.134±0.023)mm2〕相比,差异有统计学意义(P<0.05)。结论芦荟大黄素可以抑制球囊损伤后内膜的增生,并有可能对损伤后的血管重塑产生有利的影响。     

Effect of Xiongshao Capsule on the function of vascular endothelium of patients with cervical atherosclerosis

Objective:To study the effect of Xiongshao Capsule (XSC), a TCM herb that can promote blood circulation to remove blood stasis, on the endothelial dependent relaxation function, serum nitric oxide (NO), and plasma endothelin-KET-1) of the patients with cervical atherosclerosis.Methods: Forty patients were randomly divided into two groups: XSC group and Probucol group (western medicine control). In addition, 20 healthy people were set as a normal control group. Plasma ET-1, serum NO, the internal diameter of basal brachial artery, endothelial dependent flow mediated dilation (FMD) and non-endothelial dependent nitroglycerin induced dilation (NID) to the trial group before and after therapy and to the healthy control group were determined respectively. Results: Compared to the healthy control group, FMD of patients with atherosclerosis was damaged obviously, the serum NO level decreased, plasma ET-1 increased (P< 0.01), NID also decreased (P<0.05), the internal diameter of basal brachial artery has no obvious difference (P>0.05). After the patients with atherosclerosis were treated with Xiongshao Capsule for 12 weeks, FMD increased evidently, plasma ET-1 decreased, serum NO and the ratio of NO/ET-1 increased, compared with the level before therapy and Probucol group, the difference was significant (P<0.05,P<0.01), NID didn’t change obviously (P>0.05).Conclusion: XSC could regulate vascular activity factor and improve the function of endothelial dependent vascular dilation of patients with atherosclerosis.     

大鼠新型颈总动脉球囊损伤后狭窄模型的建立及其动态病理学观察

目的为经皮腔内冠状动脉成形术后再狭窄的研究提供新型的造模方法。方法SD大鼠24只，假手术组6只，模型组18只（分3个时相点5d、14d和28d，每个时相点6只动物）。用2．0Fogarty球囊导管自右股动脉插管建立大鼠左颈总动脉球囊损伤模型。每组动物于相应时相点麻醉心脏放血处死后，取损伤颈总动脉。常规固定、包埋、切片，分别做HE染色、TR-A02弹力纤维染色和Masson三色染色，在光学显微镜下病理观察。结果球囊损伤大鼠颈总动脉后，5d可见内皮细胞脱落，表面炎性细胞浸润，附壁少量血栓形成。随着时间的延长，14d动脉内膜逐渐增厚，VSMC增殖。胶原和弹力纤维组织大量增生，28d可见内膜明显不规则增生，管腔明显变窄。结论本实验成功的复制了球囊损伤术后血管狭窄动物模型，其病理改变与临床经皮腔内冠状动脉成形术后再狭窄的病理改变相似。而且该造模方法与自颈外动脉插管建立颈总动脉再狭窄模型相比失血少。创面小，操作简便迅速，有利于提高手术成功率。     

The Role of NF-kB and I-kB in Intimal Proliferation Following Balloon Catheter-induced Injury in the Rat Carotid Artery

The aim of our study was to gain insight into the molecular and cellular mechanisms of post-angioplasty restenosis using balloon catheter-induced injury model in the rat carotid artery. SD rats were subjected balloon catheterization at one side carotid artery as study group and another side as control group. Six rats were killed on the 6 h, and 3rd, 7th, 14th, 28th day after balloon-induced injury respectively. The intimal thickness and the expression of NF-κB and I-κB were detected by HE-staining, gel electrophoretic mobility shift assay （EMSA） and Western-blot methods. The results showed that： （1） The thickening of intima was observed on the 3rd day after balloon-induced injury, and it became more significant on the 7th, 14th and 28th day. The area ratio of intima/media was increased significantly （P〈0.05）; （2） The expression of NF-κB was not detectable in the control group, however, in study group, the expression of NF-κB was detected on the 6th h after balloon-induced injury, reached the peak on the 14th day, and on 28th day, strong expression of NF-κB was observed; （3） The expression of I-κB protein was reduced after balloon-induced injury, and there were significant differences between the study group and the control group （P〈0.05）. It was concluded that the alteration of NF-κB/I-κB system might play an important role in aberrant proliferation within the intima and vascular remodeling following vascular injury. To block NF-κB activation and its role in arterial restenosis initiation may potentially provide a novel therapeutic tool for the treatment and prevention of arterial restenosis.     

Effect of arsenic trioxide on inhibition of restenosis after rabbit vascular injury and its mechanism

目的　探讨应用三氧化二砷 (As2 O3)预防血管损伤后再狭窄的效果及其作用机理。方法　观察As2 O3对培养兔血管平滑肌细胞 (VSMCs)凋亡的影响。 32只新西兰白兔随机分为 2、4周实验组和对照组 ,分别 10 %As2 O32 5mg·Kg 1·d 1或等量生理盐水腹腔注射 3天 ,应用球囊损伤左颈总动脉。处死动物取血管作形态学和免疫组化检测 ,并检查肝脏、肾脏组织学变化。结果　细胞形态学和DNA电泳梯形带证实 ,As2 O3诱导培养VSMCs凋亡 ,与药物浓度和作用时间呈依赖性。与对照组相比 ,2 wk实验组血管内膜增殖面积显著减少 (P <0 0 5 ) ,4 wk组内膜面积无明显差异 ;但 2 ,4 wk组的管腔面积均有明显增大 (P均 <0 0 5 )。与对照组相比 ,实验组 2 ,4 wk免疫组化显示bcl 2表达下调 (P均 <0 0 5 ) ,Bax表达上调 (P分别 <0 0 1,0 0 5 ) ,均与相对应的血管内膜增生受抑制 ,血管腔面积扩大相吻合结论　As2 O3诱导VSMCs凋亡和有效预防实验性血管损伤后再狭窄 ,均与下调bcl 2和上调bax表达有关     

Comparative study on effects of different treatments in preventing myocardial ischemia caused by coronary artery ligation in diabetic rats

Objective: To compare the preventive effect of treatment with different methods of traditional Chinese medicine(TCM) for myocardial ischemia caused by coronary artery ligation in diabetic rats.Methods:Animal models established by streptozotocin plus coronary artery ligation were treated by modified Taoren Chengqi Decoction (MTRCQD) and different combinations of its ingredients respectively, and the effects on ischemia area, occurrence of arrhythmia, T-wave in ECG and 2 hrs post-operational survival rate were observed and compared.Results: MTRCQD and different combinations of its ingredients could reduce the area of ischemia and elevate survival rate significantly (P<0.05–0.01), especially in the group treated with MTRCQD plus leech. Improvement of T-wave was shown in the groups treated with MTRCQD or with MTRCQD plus leech.Conclusion: TCM treatment of invigorating Qi, nourishing Yin, purging Heat and activating blood circulation is an effective treatment for diabetic coronary heart disease.     

Sirolimus-eluting cobalt alloyed stents in treating patients with coronary artery disease: six-month angiographic and one-year clinical follow-up result A prospective, historically controlled, multi-center clinical study

Background  The emergence of drug-eluting stents (DES) has dramatically reduced the incidence of in-stent restenosis. This study was conducted to evaluate the safety and efficacy of sirolimus-eluting cobalt-chrome stents (Firebird 2) for treating patients with coronary artery disease.
Methods  Sixty-seven patients with de novo or non-stented restenostic coronary lesions were chosen to receive the Firebird 2 stent as the final treatment (Firebird 2 group). Another 49 consecutive patients were implanted with bare cobalt alloyed stents (Driver, Medtronic) within the previous six months and served as historical controls (control group). Baseline clinical characteristics, angiographic features, procedural results, 30-day, 6-month and 12-month clinical follow-up regarding the occurrence of major adverse cardiac events (MACE), as well as the primary endpoint of late lumen loss at 6-month angiographic follow-up were compared between the two groups.
Results  The demographic characteristics were similar between the two groups despite more patients in the Firebird 2 group who underwent previous percutaneous coronary intervention (22.4% vs 8.2%, P=0.0418) and who had diabetes mellitus (29.9% vs 12.2%, P=0.0253). In the Firebird 2 group, the mean diameter of the reference vessel was smaller ((2.79±0.46) mm vs (2.98±0.49) mm, P=0.0175) and more stents were implanted for each lesion (1.28±0.52 vs 1.10±0.30, P=0.0060). Other angiographic, procedural results and the device success rate were similar between the two groups. The MACE rate at 30-day and 3-month was the same, but significantly fewer MACE occurred in the Firebird 2 group at 6- and 12-month follow-up (1.5% vs 12.2% at 6 month, P=0.0168; 1.5% vs 26.5% at 12 month, P<0.0001). The primary endpoint of late lumen loss at 6-month angiographic follow-up was significantly reduced in the Firebird 2 group (in-stent: (0.05±0.09) mm vs (0.98±0.61) mm; in-segment: (0.05±0.18) mm vs (0.72±0.59) mm; P<0.0001) than the control group. One patient in the Firebird 2 group had in-segment restenosis (1.3%) while the rate in the control group (38.1%) was significantly higher, P<0.0001. Intravascular ultrasound examination was performed in 70.1% of patients in the Firebird 2 group and revealed that the percentage of volumetric obstruction was (1.26±1.05) %. No stent thrombosis was observed in either group at 12-month follow-up.
Conclusion  The Firebird 2 sirolimus-eluting cobalt alloyed stent is safe and feasible in treating patients with coronary artery disease.

     

Clinical Study on treatment of mid-late stage gastric carcinoma by compound Xiansu capsule () combined with chemotherapy) combined with chemotherapy

Objective: To assess the effect and mechanism of compound Xiansu capsule ( ), (XSC) combined with chemotherapy in treating gastric carcinoma of mid-late stage.Methods: Sixty-one patients of the test group were treated by XSC combined with chemotherapy and 30 patients of the control group treated with chemotherapy alone. The effect of treatment and cell mediated immunity of patients were observed.Results: The effective rate of the test group and the control group was 32.8% and 13.3% respectively (P < 0.05), the toxic reaction occurrence caused by chemotherapy was less in the former than that in the latter group (P < 0.01). The CD₈ level of patients in the test group decreased, and CD₄/CD₈ level was raised obviously, which suggested that XSC had immuno-regulating effect on T-cell.Conclusion: XSC could enhance the efficacy and reduce the toxic and side-effect of chemotherapy. To regulate the cell mediated immunity of patients is possibly its mechanism.     

球囊损伤术建立血管再狭窄鼠模型

目的 建立大鼠颈动脉球囊损伤血管再狭窄模型,观察损伤血管的组织形态学变化.方法 雄性Wistar大鼠36只,随机分为假手术组（对照组）、损伤后1d组、损伤后3d组、损伤后7d组、损伤后14 d组、损伤后28 d组,每组6只.除假手术组其余各组均利用PTCA球囊导管损伤颈动脉建立血管再狭窄模型,用光学显微镜观察损伤后不同时间血管的形态学变化.结果 球囊导管损伤术使颈动脉内皮剥脱、VSMC增殖、迁移、新生内膜增生,导致管腔狭窄.损伤后7d,内膜开始增生,14 d内膜增生最显著,28 d达到最大.结论 利用PTCA球囊导管成功建立血管再狭窄鼠模型,方法科学,能满足研究血管损伤后再狭窄的需要.     

Cutting balloon angioplasty for treatment of coronary in-stent restenosis: immediate results and 6-month outcomes

目的　研究切割球囊对支架内再狭窄的即刻和 6个月内随访效果。方法　 6 9例支架内再狭窄患者随机分配到切割球囊和普通球囊治疗组。切割球囊组 38例。球囊扩张前及扩张后即刻在定量冠状动脉造影和冠状动脉内超声下 ,测定相关参数。随访 6个月内临床改善及冠状动脉造影结果。研究终点包括出现心肌梗塞 ,需要冠状动脉搭桥或再介入治疗。结果　两组的手术成功率为 10 0 %。切割球囊组 1例患者扩张后在支架的远端出现夹层。平均随访 6 7± 2 3月。切割球囊组于术后 3和 6个月时的再狭窄率显著低于普通球囊组 (15 %VS 38%及 18%VS 4 3%,P均小于0 0 0 1)。扩张后即刻血管直径获得值在切割球囊组和普通球囊组分别为 1 72± 0 5 2mm和 1 15± 0 5 4mm ,而随访终点时切割球囊组的血管直径晚期丢失为 0 2 6± 0 0 5mm(3个月 )及 0 38± 0 0 6mm ,同时的普通球囊组丢失值为 0 78± 0 19mm(3个月 )及 0 89± 0 16mm。对于支架体部狭窄 ,普通球囊难以固定 ,扩张时移动明显 ,而切割球囊较易于固定 ,扩张时罕见移动。结论　切割球囊治疗支架内再狭窄效果可靠 ,安全 ,容易操作。再狭窄率低 ,手术费用相对易于患者接受 ,是一个较有前途的治疗手段。     

Crush stenting in treating coronary bifurcate lesions: paclitaxel eluting stents versus sirolimus eluting stents

Background Because no data regarding the comparison of crush stenting with paclitaxel （PES） or sirolimus eluting stents （SES） for coronary bifurcate lesions have been reported, we compared the clinical outcomes of these two types of stents. Methods Two hundred and thirty patients with 242 bifurcate lesions were enrolled in a prospective, nonrandomized trial Primary endpoints included myocardial infarction, cardiac death and target vessel revascularization at 8 months. Results All patients were followed up clinically and 82% angiographically at 8 months. Final kissing balloon inflation was performed in 72% in the PES and 75% in the SES groups （P〉0.05）. Compared to the SES group, PES group had a higher late loss and incidence of restenosis （P=0.04） in the prebifurcation vessel segment. The postbifurcation vessel segment in the PES group had a greater late loss （（0.7±0.6） mm vs （0.3±0.4） mm, P〈0.001） and higher restenosis in the side branch （25.5% vs 15.6%, P=0.04） when compared to the SES group. There was significant difference of insegment restenosis in the entire main vessel between PES and SES groups （P=0.004）. Target lesion revascularization was more frequently seen in the PES group as compared to the SES group （P=0.01）. There was significant difference in the accumulative MACE between these two groups （P=-0.01）. The survival rate free from target lesion revascularization was significantly higher in the SES group when compared to the PES group （P〈0.001）. Conclusion SES is superior to PES in reducing restenosis and target lesion revascularization by 8-month follow-up after crush stenting for bifurcate lesions.     

兔颈动脉球囊成形术后MMP9和TIMP1的原位表达

目的 :观察球囊损伤后基质金属蛋白酶 9( MMP9)及其组织特异性抑制因子1 ( TIMP1 )在血管原位表达的动态变化 ,探讨其在球囊成形术后再狭窄 ( RS)形成中的作用机制。方法 :5 0只兔子随机分成正常组、术后 3、7、2 1、90天组 ,正常组不做处理 ,原位杂交方法观察 MMP9及 TIMP1的 m RNA改变。结果 :正常对照组 MMP9m RNA未见阳性表达 ;3d时 ,可见整个中层广泛阳性表达 ;7d时 ,新生内膜阳性表达 ,中层未见阳性表达 ;球囊损伤后随时间延长表达强度及范围逐渐减小 ;90 d时 ,未见阳性表达。正常对照组血管内皮细胞可见 TIMP1基础表达 ;3d时 ,中层广泛阳性表达 ;7d时 ,新生内膜阳性表达 ,中层未见阳性表达 ;2 1 d时 ,新生内膜阳性表达 ,中层未见阳性表达 ;90 d时 ,仍有新生内膜阳性表达。结论 :血管球囊成形术后 MMP9及 TIMP1 m RNA异常表达可能与血管平滑肌细胞迁移、新生内膜形成及血管重塑密切相关     

经皮腔内冠状动脉成形术后再狭窄的机制及防治研究进展

经皮腔内冠状动脉成形术(PTCA)广泛应用于冠心病患者,尽管初始疗效较好,但术后再狭窄率较高。本文从术后发生再狭窄的机制及其防治两个方面,总结了近几年国内、外研究的现状和进展,指出新生内膜增生和冠脉重塑不良可能是发生再狭窄的主要机制;对于再狭窄的防治主要有药物、支架、基因、切割球囊PTCA和放射等方法,并指出了目前存在的问题和今后研究的方向。     

药物涂层球囊在冠状动脉大血管原位及长病变中的应用

目的：评价药物涂层球囊（DCB）在治疗冠状动脉大血管原位病变（冠状动脉病变参考直径≥2.8 mm）以及大血管原位长病变（冠状动脉病变参考直径≥2.8 mm，病变长度≥20 mm）中的临床疗效。方法：选取2015年4月至2020年12月在杭州师范大学附属医院心内科诊治的患者80例，均为给予DCB治疗的冠状动脉大血管原位原发病变。采用计算机定量冠脉造影分析软件（QCA）分别对所纳入患者术前、术后即刻及随访三个不同时刻的冠脉造影图像进行分析，评估DCB的疗效；将入选的患者按照靶血管病变长度分成2组，即病变长度＜20 mm组（n =45）和病变长度≥20 mm组（n =35），评估DCB治疗冠脉大血管原位长病变的疗效。结果：所纳入病例靶血管的病变长度为（15.71±5.98）mm，参考直径为（3.22±0.34）mm，在（15.89±9.34）个月的随访时间里，无患者发生急性心肌梗死、严重心律失常、心源性死亡及卒中。所有随访患者中未出现再次靶血管病变血运重建病例，随访时的晚期管腔丢失为（-0.01±0.26）mm。不同病变长度组患者晚期管腔丢失差异无统计学意义[（0.003±0.3）mm vs.（ -0.03±0.23）mm，P =0.615]。结论：DCB治疗冠状动脉大血管原位病变及原位长病变安全、有效，并能减少冠脉靶病变的晚期管腔丢失。     

血管内超声对血管内放射防治猪受损髂动脉狭窄形成的疗效观察

目的：通过血管内超声(IVUS)观察血管内放射(IR)对猪受损髂动脉形态学改变的影响，在体情况下探讨IR治疗对管腔重构的作用。方法：对中国小型猪髂动脉进行血管造影及IVUS检查后行球囊扩张损伤术。实验组通过置源管将高剂量铱—192(^192Ir)后装源对受损髂动脉施予总量为20Gy的IR治疗，而损伤对照组仅在受损髂动脉置入假源。动脉损伤后第28天时再次进行血管造影和IVUS检查。通过IVUS测量血管外弹力膜(EEM)横截面积、管腔横截面积检查、管腔最大径和最小径以及面积狭窄率和直径狭窄率。结果：IVUS检查发现，与损伤前相比，动脉损伤后28天时EEM与管腔横截面积以及管腔最小径均明显缩小（P〈0．05)，表明动脉受损后28天时发生明显负性重构(血管回缩)，导致了管腔明显狭窄；20GyIR后，管腔横截面积与管腔最小径均较损伤对照组明显增加(P〈0．05)，EEM横截面积也较对照组有所增加(但末达到统计学意义)，总量为20GyIR治疗使管腔狭窄显著减轻。结论：IUVS检查证实：负性重构是猪髂动脉球囊损伤后狭窄形成的重要原因；20GyIR可明显减轻动脉内膜损伤后狭窄形成，IR防治受损动脉狭窄形成的原因可能与改善血管负性重构有关。     

Alleviation of hypoxic pulmonary vascular structural remodeling by L-arginine

目的探讨L-精氨酸(L-Arg)对低氧性肺血管结构重建的干预作用及其可能机制.方法将18只Wistar大鼠配伍后随机分为对照组、低氧组和低氧+L-Arg组(共6个配伍组).以右心导管法测定肺动脉压力,并对大鼠肺组织标本进行显微结构观测和超微结构观察,同时以分光光度法测定血浆一氧化氮(NO)含量,并对肺组织以内皮素-1(ET-1) cRNA探针进行原位杂交,研究肺动脉内皮细胞ET-1 mRNA的表达.结果低氧组大鼠肺动脉平均压明显高于对照组(20.33±2.18?mm?Hg vs 15.38±1.05?mm?Hg, P<0.05).低氧后大鼠肺血管显微及超微结构发生明显改变,肺血管结构重建形成.同时低氧组大鼠血浆NO间接含量明显低于对照组 (P<0.05 ).低氧后肺动脉内皮细胞ET-1 mRNA表达明显增强.然而,低氧+L-Arg组大鼠PAMP较低氧组明显降低(16.73±1.35?mm?Hg vs 20.33±2.18?mm?Hg, P<0.05).L-Arg缓解了低氧性肺血管结构重建的形成.同时低氧+L-Arg组大鼠血浆NO间接含量明显高于低氧组(P<0.05).L-Arg使低氧大鼠肺动脉内皮细胞ET-1 mRNA表达明显受抑制.结论 L-Arg对低氧性肺血管结构重建以及低氧性肺动脉高压的形成有重要的调节作用,其机制可能与通过促进低氧大鼠体内NO生成,从而抑制肺动脉内皮细胞ET-1 mRNA表达有一定的关系.