局部应用紫杉醇预防兔移植静脉再狭窄

目的探讨局部应用紫杉醇对移植静脉再狭窄的预防作用。方法将96只兔随机分为3组，对照组，组Ⅰ，组Ⅱ，每组32只。3组兔均行颈外静脉与颈总动脉旁路移植术，紫杉醇与生物蛋白胶混合物局部喷涂于组Ⅰ（紫杉醇1μg）和组Ⅱ（紫杉醇8μg）移植血管表面，对照组单纯喷涂生物蛋白胶。分别于术后1，2，4和6周采集颈静脉标本，进行形态学和免疫组织化学分析。结果术后1，2，4和6周组Ⅱ移植血管内膜厚度均较对照组减少（30．10±4．50pmVS．48．20±9．16μm，40．70±6．91μmVS．54．20±8．67μm，54．70±7．11FmVS．68．60±13．72μm，68．70±8．24μmVS．76．40±12．98μm，P〈0．05）；组Ⅰ和组ⅡCD8和金属硫蛋白阳性细胞表达在各时间段均较对照组显著减少（P〈0．05）。结论在兔颈动脉旁路移植模型中，静脉移植血管周围应用紫杉醇可以抑制移植血管新生内膜的增生。

Local Application of Paclitaxel for Prevention Restenosis of Vein Graft in Rabbits

Objective To investigate the effect of keeping implanted vein graft from restenosis by local application of paclitaxel. Methods Ninety-six New Zealand rabbits were randomly divided into three groups, control group （n=32）, group Ⅰ （n=32）, group Ⅱ （n=32）. The vein graft stenosis model was made in all rabbits. In group I and group Ⅱ , 1μg and 8μg of paclitaxel was applied locally in pluronic gelatin respectively. There were no local treatment in control group. Grafts were harvested at 1, 2, 4, and 6 weeks and underwent morphological analysis as well as immunohistochemical analysis. Results The intimal thickness in group Ⅱ were significantly decreased compared to those in control group at 1,2,4, and 6 weeks after operation （30. 10±4.50μm vs. 48.20± 9.16μm, 40. 70± 6. 91μm vs. 54. 20± 8.67μm, 54. 70± 7. 11μm vs. 68. 60±13.72μm, and 68. 70± 8. 24μm vs. 76.40±12. 98μm, P〈0. 05）. The CD8 positive cells and metallothionein positive cells in group Ⅰ and group Ⅱ were significantly decreased compared to those in control group （P 〈 0. 05）. Conclusion The results suggest that perivascular application of paclitaxel inhibits neointimal hyperplasia of vein grafts in a rabbit model, and paclitaxel may have a therapeutic potential for the treatment of vein graft disease.