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目的:采用袖套法改良大鼠自体移植静脉内膜增生模型,观察肝素与阿魏酸钠对移植静脉内膜增生的影响,以减少再狭窄率,为防治桥管再狭窄提供理论依据。方法:采用袖套法将大鼠自体颈外静脉移植入同侧颈总动脉,分别给予肝素(800 U/kg,ip,bid)、阿魏酸钠(100 mg.kg-1.d-1,iv)及两者联合用药至术后2周。应用病理形态学方法通过计算机图像分析,观察术后各组大鼠移植静脉内膜增生情况及药物对其影响;应用增殖细胞核抗原(PCNA)免疫组织化学方法检测移植静脉血管平滑肌细胞(VSMC)中PCNA表达的变化。结果:阿魏酸钠组和阿魏酸钠加肝素组与移植对照组相比,移植静脉内膜增生程度显著减轻(均P<0.05),PCNA阳性细胞比例显著下降(均P<0.05);肝素组与移植对照组相比,移植静脉内膜增生受到一定的抑制,但差异无统计学意义,肝素组移植静脉PCNA阳性细胞比例与移植对照组相比差异无统计学意义。结论:阿魏酸钠能显著抑制移植静脉内膜增生,而肝素无显著抑制作用;袖套法静脉移植模型设计科学,手术操作简便,成功率高。
OBJECTIVE: To improve the intimal hyperplasia model of autologous transplantation in rats by cuff method and observe the effect of heparin and sodium ferulate on the intimal hyperplasia of vein grafts in order to reduce the rate of restenosis and provide a theoretical basis for the prevention and treatment of restenosis. Methods: The external jugular vein was transplanted into the ipsilateral common carotid arteries by cuff method. Heparin (800 U / kg, ip, bid), sodium ferulate (100 mg.kg-1.d-1 , iv) and their combination until 2 weeks after surgery. Pathological morphology was used to analyze the intimal hyperplasia of the vein graft and the effect of the drug on the rats after operation. The proliferating cell nuclear antigen (PCNA) immunohistochemical method was used to detect the vascular endothelial growth factor PCNA expression changes. Results: Compared with the control group, the degree of intimal hyperplasia was significantly decreased in both sodium ferulate group and sodium ferulate plus heparin group (all P <0.05), and the percentage of PCNA positive cells was significantly decreased (all P <0.05). Heparin group compared with transplantation control group, graft venous intimal hyperplasia was inhibited, but the difference was not statistically significant, heparin group vein graft PCNA positive cells compared with the control group, the difference was not statistically significant. CONCLUSION: Sodium ferulate can significantly inhibit the intimal hyperplasia of vein graft without heparin, and the cuff vein graft model is of scientific design. The operation is simple and the success rate is high.