巴曲酶对犬颈总动脉人工血管旁路术后远端吻合口内膜增生的影响

目的 研究人工血管旁路术后远端吻合口局部内膜增生的形态学表现、部分炎症因子及生长因子的表达及药物巴曲酶对其的影响.方法 建立12只犬左颈总动脉膨体聚四氟乙烯(eVrrE)人工血管旁路移植模型,随机分为巴曲酶组和对照组,28 d后吻合口局部取材,应用HE、Masson染色、免疫组化(IHC)、逆转录聚合酶链反应(RT-PCR)、免疫印迹(Western Blot)等实验方法 观察吻合口内膜厚度、胞外基质(ECM)相对含量、新生内膜平滑肌细胞增殖率及单核细胞趋化蛋白.1(MCP-1)、血小板源牛长因子B(PDGF-B)mRNA和蛋白表达,并用半定量方法 比较两组间的差异.结果 术后28d,远端吻合口均已形成有内皮细胞(EC)覆盖的新生内膜,且均表达MCP-1及PDGF.B.实验组与对照组相比,其吻合口新生内膜厚度明显减少(381.3±144.7)μm对(213.8±29.0)μm,P=0.036],胞外基质相对含量明显降低(P=0.006),MCP-1表达量明显下降(RT-PCR P=0.025,Western Blot P=0.016),而PDGF-B表达量差异无统计学意义(RT-PCR P=0.055,WesternBlot P=0.337),平滑肌细胞增殖率无明显差异(P=0.109).结论 巴曲酶可抑制人工血管旁路术后早期吻合口新生内膜胞外基质的沉积和MCP-1的表达,抑制新生内膜厚度,为提高人工血管移植远期通畅率提供新的临床应用及研究思路.

Effects of Batroxobin on distal anastomotic intimal hyperplasia after expanded polytetrafluoroethylene bypass grafting in dog common carotid artery

Objective To study the morphological behavior ,the expression of MCP-1 and PDGF-B of distal anastomotic neointima after expanded polytetrafluoroethylene (ePTFE) bypass grafting. And to identify the effects of Batroxobin (BX) on distal anastomotic intimal hyperplasia. Methods 12 adult mongrel dogs underwent end to side bypass grafting in left common carotid artery using ePTFE vascular graft (6mm in diameter, 5cm in length) were divided randomly into two groups. All 12 bypass grafts were removed 28 days after grafting and distal anastomotic parts were obtained . Using HE, Masson , IHC, RT-PCR and western blot , we analyzed the thickness, relative content of ECM, SMC PCNA index, expression of MCP-1 and PDGF-B in distal anastomotic neointima. And we compared the differences between the two groups. Results 28 day after grafting , the neointima was formed by SMC and ECM and was covered by epithelial cells. After using BX , the thickness of neointima was reduced (381.3±144.7) μm versus (213.8±29.0) μm, P <0.05] and the relative content of ECM were significantly decreased(P =0.006). The PCNA index(P = 0.109) and PDGF-B level (P =0.055 by RT-PCR and P = 0.337 by WB) between the two groups had no significant difference . MCP-1 level was markedly decreased (P = 0.025 by RT-PCR and P = 0.016 by WB). Conclusions Using BX after ePTFE grafting could effectively reduce the relative content of ECM ,rnduce the expression of MCP-1 and decrease the thickness of neointima in the early time.