全身炎症反应对髂动脉损伤后狭窄的影响

目的用脂多糖(LPS)诱导加重猪全身炎症反应,观察其对髂动脉损伤后狭窄的影响。方法12头小型猪随机分为两组,实验组(n=6)给予静脉注射LPS,对照组(n=6)给予生理盐水。所有动物都行右髂动脉内膜剥脱术,并于术前、术后4h和术后24h抽取静脉血,行酶联免疫吸附反应检查(ELISA)测定炎症细胞因子肿瘤坏死因子-α(TNF-α)血浆浓度。术后28d处死动物,取术侧血管和对侧髂动脉作为对照行病理切片观察管腔变化情况。结果(1)在对照组和实验组中,术后4hTNF-α的血浆浓度均比术前明显升高(P<0.05),并且实验组的升高水平显著高于正常对照组(P<0.05)。(2)病理切片发现,4周后实验组和对照组均有新生内膜形成,导致血管管腔狭窄。(3)在实验组观察到比对照组更大的新生内膜面积和严重的狭窄程度。结论血管损伤后早期的全身炎症反应对后期的新生内膜形成起重要作用。

Effects of systemic inflammation increases on neointimal formation after balloon injury in porcine

Objective To investigate how systemic inflammation degree increased by bacterial lipopolysaccharide(LPS) influence the formation of stenosis after the balloon injury in porcine ilica arteries. Method Twelve adult miniswines were randomly divided into two groups. One group(n=6) was injected LPS(6μg/swine)before balloon injury and the other group was injected saline as control. Iliac artery balloon injury was performed to all animals. A systemic marker of inflammation(serum tumor necrosis factor-α levels)was measured by ELISA before this procedure and four and twenty four hours later to evaluate the degree of inflammation. Four weeks after the injury morphometric analysis was performed on injured arterial segments and normal iliac artery to measure the neointimal area, the area of lumen, internal elastic lamina and percent stenosis. Results (1) Four hours after injury, the concentration of serum TNF-αincreased in all animals and the degree of LPS treated group was higher than that of control group.(2)Four weeks later, both neointimal formation and negative remolding contribute to restenosis in control group.(3)the neointimal area and the degree of stenosis in LPS-treated animals were increased compared with controls. Conclusions Inflammation immediately after arterial injury promotes neointimal formation and luminal loss.