粒细胞-巨噬细胞集落刺激因子对球囊损伤内膜修复的影响

目的建立兔髂动脉球囊损伤模型,观察粒细胞巨噬细胞集落刺激因子(GM CSF)对损伤内膜修复的影响。方法健康雄性新西兰大白兔24只随机分为GM CSF组和对照组。GM CSF组皮下注射GM CSF10μg·kg1·d1,对照组皮下注射同等量生理盐水。7d后球囊扩张损伤髂动脉。4周后提取损伤动脉标本,观察内皮修复、内膜增生情况并测定病理形态学参数。结果术后4周病理组织学见GM CSF组内膜增生程度明显轻于对照组,新生内膜中血管平滑肌细胞和纤维组织明显少于对照组,内皮较完整、光滑,管腔狭窄程度较轻。形态学参数见GM CSF组的管腔面积明显大于对照组(1.27mm2±0.31mm2vs0.92mm2±0.24mm2),新生内膜面积与内膜增生百分比明显小于对照组(0.85mm2±0.34mm2vs1.18mm2±0.38mm2;40%±7%vs55%±6%)。结论GM CSF能促进损伤内膜修复,减少内膜增生,降低再狭窄率。

Effect of granulocyte-macrophage colony stimulating factor on the repair of vessel intima damaged by balloon

OBJECTIVE: To observe the effect of granulocyte-macrophage colony stimulating factor (GM-CSF) on the repair of damaged iliac arteries. METHODS: Twenty-four male New Zealand White rabbits were randomized to two equal groups: GM-CSF group receiving subcutaneous injection of GM-CSF (10 microg.kg(-1).d(-1)), and control group receiving subcutaneous injection of normal saline. Seven days later all rabbits underwent insertion and expansion of balloon into the right iliac arteries so as to cause damage. Four weeks after the operation the operated iliac arteries of the GM-CSF group and the left iliac arteries of the control group were collected to undergo pathological examination. The repair and hyperplasia of intima were observed by microscopy and the indices of restenosis were evaluated by computerized planimetry. RESULTS: Histological examination showed that hyperplasia of neogenetic intima was lighter, numbers of vascular smooth muscle cells and fibrous tissue were less, degree of lumen stenosis was slighter, and the endothelium was more integrated in the GM-CSF group in comparison with the control group. Morphometry showed that the lumen area of the GM-CSF group was 1.27 mm(2) +/- 0.31 mm(2), significantly larger than that of the control group (0.92 mm(2) +/- 0.24 mm(2), P < 0.05). The area of neogenetic intima of the GM-CSF group was 0.85 mm(2) +/- 0.34 mm(2), significant smaller than that of the control group (1.18 +/- 0.38, P < 0.05), and the percentage of intimal hyperplasia of the GM-CSF group was 40% +/- 7%; significantly lower than that of the control group (55% +/- 6%, P < 0.05). CONCLUSION: GM-CSF promotes the repair of intima, reduces the new intima formation, and decreases the rate of restenosis.