血管重塑在血管介入治疗后再狭窄中作用的实验研究How Much does Vascular Remodeling Contribute to Restenosis after Interventional Therapy? An Experimental Study on Rabbits Atheroscleristic Iliac Artery Model
贾新未,霍勇,朱国英
摘要(Abstract)：
观察血管成形术后血管壁各部分变化在再狭窄发生中的作用。利用家兔骼动脉粥样硬化模型行球囊扩张术，用组织形态测量的方法研究术后即刻（急性组，n=20）及术后4周再狭窄发生时（慢性组，n=23）血管内膜面积、中膜面积、腔面积、内弹力板围绕面积、外弹力极围绕面积的变化。以血管直径减少扩张即刻管径的30％为再狭窄的标准，将慢性组进一步分为非再狭窄亚组（NRS，n=9）与再狭窄亚组（RS，n=14），对此二亚组血管形态测量结果进行进一步研究。慢性组腔面积较急性组腔面积显著减小0．48mm（0．38±0．20vs0．86±0．23，P＜0．001），内膜增生仅0．12mm（0．40±0．26vs0．28±0．09，PM0．05），而内弹力板围绕面积则减少0．36mm（1．14±0．27vs0．78±0．31，P＜0．001）。内膜增生仅可解释25％后期管腔面积损失。对慢性组进一步分组研究发现，两亚组内膜增生面积无差别（0．41±0．310．39±0．16VS，P=NS），而再狭窄亚组内弹力板围绕面积却显著减小（0．6±0．350．94±0．14vs，P＜0．05）。再狭窄亚组内弹力板的明显回缩是导致两亚组之间管腔面积（0．27±0．10vs0．55±0．10，PM0．001）显著不同的主要原因。内膜增生与血管收缩（重塑）共同促进血管成形术后管腔面积减小，但血管收缩（重塑?
关键词(KeyWords)： 血管成形术;再狭窄;冠状动脉;重构
基金项目(Foundation):
作者(Author): 贾新未,霍勇,朱国英
参考文献(References)：
- 1 Curier JW, David P, et al. Restenosis after Percutaneoustransluminal coronary angioplasty: Have we been aiming atthe wrong target? J Am Coll Cardial, 1995, 25: 516.
- 2 Casscells W. Migration of smooth muscle cells and endthelialcells: Critical events in restenosis. Circulation, 1992, 86:723-729.
- 3 Strauss BE, Chisholm RJ, Keeley PW, et al. Extraceliularmatrix remodeling after balloon angiopboty injury in a rabbit medel of restenosis. Circ Res, 1994, 75: 650.
- 4 Karim MA, Miller DD, Farrar MA, et al. Histomorphometric and biochemical correlates of arterrial procollagengene expression during vascular repair after expeimentalangioplasty. Circulation, 1995, 91: 2049.
- 5 Ardissino D, Somma SD, Kubica J,et al. Influence of elasticrecoil in restenosis after sucessful coronary angioplasty inunstable angina Pectoris. Am J Cardial, 1993, 71: 659.
- 6 Eilis SG,Roubin GS, King SR,et al. Angiographic and clinical predicators of acute closure after native vessel coronaryangioplasty. Circulation, 1987, 77: 372.
- 7 Isner JM- Vascular remodeling, I think I shunk the artery.Circuletion, 1994, 89: 2397