白芍总苷对大鼠球囊损伤再狭窄的 作用及机制研究

目的 分别应用白芍总苷灌胃及白芍总苷浸泡球囊法观察大鼠球囊损伤前后及白芍总苷干预对 Th17、Treg 细胞的影响。方法 将SD 大鼠随机分为对照组、球囊损伤组、白芍总苷灌胃组及白芍总苷浸泡 球囊组。对照组采用生理盐水灌胃4 d 后行假手术，术后生理盐水灌胃13 d ；球囊损伤组采用生理盐水灌胃 4 d 后在左侧颈总动脉行球囊损伤，术后生理盐水灌胃13 d ；白芍总苷灌胃组采用白芍总苷灌胃4 d 后行球囊 损伤，术后白芍总苷灌胃13 d ；白芍总苷浸泡球囊组采用生理盐水灌胃4 d 后行球囊损伤，术前将球囊浸泡于 白芍总苷稀释液中4 h，术后生理盐水灌胃13 d。各组术后14 d 取左侧颈总动脉，采用流式细胞术分别检测各 组脾脏中Th17、Treg 细胞占CD4+T 细胞的百分比，计算Th17/Treg 细胞比例，损伤血管行苏木精- 伊红染色， 观察内膜变化。结果 球囊损伤组管腔面积较对照组小，内膜面积及内膜面积/ 中膜面积比值较对照组大 （P <0.05）；白芍总苷灌胃组管腔面积较球囊损伤组高，内膜面积及内膜面积/ 中膜面积比值较球囊损伤组 减小，但高于对照组（P <0.05）；白芍总苷浸泡球囊组管腔面积较白芍总苷灌胃组大，内膜面积及内膜面积/ 中膜面积比值较白芍总苷灌胃组小，但高于对照组（P <0.05）。球囊损伤组Th17 细胞占CD4+T 细胞的百分比、 Th17/Treg 高于白芍总苷灌胃组、白芍总苷浸泡球囊组及对照组（P <0.05）；白芍总苷浸泡球囊组低于白芍 总苷灌胃组，而高于对照组（P <0.05）。白芍总苷灌胃组Treg 细胞占CD4+T 细胞的百分比高于球囊损伤组 及对照组（P <0.05），白芍总苷浸泡球囊组Treg 细胞占CD4+T 细胞的百分比高于白芍总苷灌胃组（P <0.05）。 结论 白芍总苷通过调节Th17、Treg 细胞数量调节细胞免疫失衡，减轻球囊损伤后血管狭窄，且白芍总苷浸 泡球囊法较白芍总苷灌胃法效果更佳。

Studies on effects of total glucosides of paeony on restenosis and mechanism in rats after carotid artery balloon injury

Objective To observe the changes in Th17 / Treg cells in rats after carotid artery balloon injury and the intervention of total glucosides of paeony. Methods SD rats were equally and randomly divided into 4 groups: the control group, the balloon injury group, the total glucosides of paeony gavage group and the total glucosides of paeony immersion group. The control group received sham operation. The left common carotid artery was injured by balloon in the balloon injury group and the total glucosides of paeony gavage group. The artery was injured by balloon immersed total glucosides of paeony in the total glucosides of paeony immersion group. The total glucosides of paeony gavage group was administered total glucosides of paeony daily by gavage, which began 4 days before operation continued until harvesting. The control group, the balloon injury group and the total glucosides of paeony immersion group were administered normal saline daily by gavage. The rats were executed under anesthesia at 14 days after operation. The proportions of Th17 and Treg cells in the spleen of rats were detected by flow cytometry. The left common carotid artery was stained with hematoxylin-eosin, and neointimal were assayed. Results The lumen area in the balloon injury group was smaller than that in the control group, and the intimal area and intima / media area ratio were higher than those in the control group (P < 0.05). The lumen area in the total glucosides of paeony gavage group was larger than that in the balloon injury group, and the intimal area and intimal area / media area ratio in the balloon injury group were lower than those in the balloon injury group, but higher than those in the control group (P < 0.05). The lumen area in the total glucosides of paeony immersion group was larger than that in the total glucosides of paeony gavage group, and the intimal area and intima-media area ratio were smaller than those in the total glucosides of paeony gavage group, but higher than those in the control group (P < 0.05). The percentage of Th17 cells in CD4+T cells and Th17/Treg in balloon injury group were higher than those in total glucosides of paeony gavage group, total glucosides of paeony immersion group and control group (P < 0.05), while those in total glucosides of paeony immersion group were lower than those in total glucosides of paeony gavage group, but higher than those in control group (P < 0.05). The percentage of Treg cells in CD4+T cells in total glucosides of paeony gavage group was higher than that in balloon injury group and control group, and the percentage of Treg cells in CD4+T cells in total glucosides of paeony immersion group was higher than that in total glucosides of paeony gavage group. Conclusions Total glucosides of paeony can regulate the balance of Th17 and Treg cells, may contribute to lighten the restenosis of injured vessels. Local application of balloon immersed total glucosides of paeony was better than gavage to inhibit the restenosis of inflammatory vessels.