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目的 研究血管成型术后降脂药物抑制动脉再狭窄形成的作用及其作用机制。方法 应用球囊导管对家兔主动脉 ,髂及股动脉造成去内膜损伤以观察使用降血脂药物simvastatin +gemfibrozil或单一使用simvastatin 6星期后对内膜生长因子包括血小板源生长因子 (PDGF B) ,转移生长因子 1(TGF 1) ,碱性纤维母细胞生长因子 (bFGF)以及血清总胆固醇 (TC)和甘油三脂 (TG)的影响。结果 给予降血脂药 6周的两组家兔 ,虽同时摄入高胆固醇但血清TC和TG(simvastatin +gemfibrozil组 )水平仅有轻度或中度升高。此外 ,还观察到血清TC水平和内膜 /中膜比值呈正相关 (r=0 5 873,P <0 0 5 )。免疫组化染色及RT PCR扩增检测均显示simvastastin +gemfibrozil可抑制去内皮手术后内膜PDGF B的释放。RT PCR还显示两组治疗组新生内膜内均有TGF 1表达增加。但手术组及治疗组动物受损伤动脉壁的平滑肌细胞内bFGFmRNA无明显改变。结论 降脂药simvastatin和gemfibrozil除具有降血脂功能外 ,还影响去内膜手术损伤后动脉新生内膜内PDGF B和TGF 1的释放。
Objective To study the effect of lipid-lowering drugs on the inhibition of arterial restenosis after angioplasty and its mechanism. Methods Endarterectomy was induced by a balloon catheter in the aorta, iliac and femoral arteries of rabbits to observe the effects of simvastatin plus gemfibrozil (hypolipidemic drugs) or simvastatin alone on endometrial growth factor (PDGF B), including platelet derived growth factor (PDGF B) , Transforming growth factor 1 (TGF 1), basic fibroblast growth factor (bFGF) and serum total cholesterol (TC) and triglyceride (TG). Results In the two groups of rabbits given lipid-lowering drugs for 6 weeks, the levels of serum TC and TG (simvastatin plus gemfibrozil group) were only mildly or moderately elevated, even though high cholesterol was taken simultaneously. In addition, there was a positive correlation between serum TC level and intima / media ratio (r = 0 5 873, P <0 05). Immunohistochemical staining and RT PCR amplification showed that simvastastin + gemfibrozil could inhibit the release of PDGF B from endothelium after endothelium-derived surgery. RT PCR also showed increased TGF-1 expression in neointima of both treatment groups. However, there was no significant change in bFGFmRNA in the smooth muscle cells of injured arterial wall in the operation and treatment groups. Conclusions The lipid-lowering drugs simvastatin and gemfibrozil not only have the function of lowering blood fat, but also affect the release of PDGF B and TGF 1 in the neointimal of endarterectomy after endarterectomy.