摘要
目的观察血管成形术后,病变近端正常参考血管重构的发生以及与病变部位血管重构的关系,并观察了粒细胞-巨噬细胞集落刺激因子(GM—CSF)对血管重构的影响。方法健康新西兰大白兔28只随机分为GM-CSF组和单纯损伤组。GM—CSF组皮下注射GM—CSF10μg·kg^-1·d^-1,单纯损伤组皮下注射同等量生理盐水。7d后球囊扩张损伤髂动脉。分别于术前、术后4周耳缘静脉采血检测一氧化氮(NO)浓度;4周后提取损伤动脉标本,观察内膜增生情况并测定病理形态学参数。结果术后4周GM—CSF组NO浓度(98±10)μmol/L高于单纯损伤组(83±12)μmol/L。单纯损伤组球囊损伤处血管残余管腔面积(LA)小于GM—CSF组[(0.87±0.40)mm^2vs(1.34±0.52)mm^2,P〈0.05],损伤处内膜+中膜面积(I+M)大于单纯损伤组[(2.62±0.48)mm^2 vs (2.26±0.43)mm^2,P〈0.05],两组损伤处外弹力膜环绕面积(EELA)差异无统计学意义[(3.48±0.80)mm^2 vs(3.60±0.91)mm^2,P〉0.05]。单纯损伤组参考血管LA小于GM-CSF组[(1.60±0.48)mm^2。vs(1.99±0.54)mm^2,P〈0.05],两组参考血管I+M无明显差异,LA与I+M之间不存在相关性,而参考血管EELA与LA及I+M之间有明显的相关性(r=0.91,P〈0.001;r=0.685,P〈0.001)。两组参考血管LA、EELA与损伤处血管LA、EELA也明显相关(r=0.919,P〈0.001;r=0.909,P〈0.001)。结论血管重构不仅发生在病变血管,同时也发生在近端参考血管。GM-CSF可以促进受损内皮细胞修复,改善负性血管重构。
Objective To observe the correlation of the arterial remodeling at the reference site and the lesion site and the effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) on arterial remodeling. Methods 28 healthy New Zealand White rabbits were randomized to 2 equal groups : GM-CSF group receiving subcutaneous injection of GM-CSF ( 10 μg · kg^-1 · d^-1 ) for 7 days, and pure damage group given subcutaneous injection of equivalent normal saline foe 7 days. Seven days later the iliac arteries of all animals were damaged by balloon. The levels of nitrogen monoxide (NO) were detected before and 4 weeks after angioplasty. Histological sections of iliac from rabbits killed 4 weeks after angioplasty were analyzed. Lumen area ( LA), external elastic lamina area ( EELA), and intimal plus medial areas ( I ± M) were measured at the lesion(L) and reference(R) sites. Results The NO levels 4 weeks later of the GM-CSF group was 98 ± 10 p.mol/L, significantly higher than that of the pure damage group (83 ± 12 μmol/L, P 〈 0. 05). Morphometrie analysis showed that the LA^L) of the pure damage group was (O. 87 ± 0. 40 ) mm^2, significantly smaller than that of the GM-CSF group [ ( 1.34 ± 0. 52 ) mm^2, P 〈 0. 05 ]. The I ± M(L) of the pure damage group was (2. 62 ± 0. 48 ) mm^2, significantly greater than that of the GM-CSF group [ ( 2. 26 ± 0. 43)mm2, P 〈0. 05]. There was no statistical significance in the EEL(L) between the 2 groups [ (3.48 ± 0. 80) mm2 versus ( 3.60 ± 0. 91 ) mm^2, P 〉 0.05 ]. Morphometrie analysis showed that the LA(R) of the pure damage group was (1. 60 ± 0. 48 ) mm^2, significantly smaller than that of the GM-CSF group [ ( 1.99 ± 0. 54)mm^2 ,P 〈0. 05] , whereas there was no statistical significance in the I ± M(R) between the 2 groups. In both groups, LA(R) was significantly correlated with LA(L) (r=0. 919, P 〈 0.001 ); and EELA(R) was significantly correlated with EELA(L) ( r = 0. 909, P 〈 0. 001 ) and I ± M(R) ( r = 0. 685 ; P 〈 0. 001 ). Conclusion Remodeling affects both the lesion and the reference sites and appears to occur in parallel and proportionately at both sites. GM-CSF treatment increases re-endothelialization of the injured artery and inhibits unfavorable remodeling.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2008年第36期2566-2569,共4页
National Medical Journal of China
基金
山东省自然科学基金资助项目(Y2005C70)
山东省科技攻关计划资助项目(2007GG20002045)