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目的 观察犬冠状动脉支架植入术后血管内膜凋亡及凋亡相关基因蛋白表达的动态变化。方法 15只犬进行冠状动脉左回旋支支架植入术 ,前降支相应血管作为对照 ,分别于术后 1周、4周和 12周处死 ,进行病理学检查、TUNEL法和透射电镜检测凋亡细胞、PCNA和Bcl xl免疫组织化学染色以及Bcl xl蛋白质印迹杂交。结果 支架植入术后 1～ 12周内膜面积持续增加 ;正常血管未见凋亡细胞和PCNA阳性细胞 ,术后 1周内膜中凋亡细胞阳性率和PCNA阳性细胞率均达高峰 ,术后 4周和 12周不断降低 ,但凋亡细胞阳性率在各时间段均低于PCNA阳性细胞率 ;Bcl xl免疫组织化学染色和蛋白印迹杂交均显示正常对照血管偶见表达 ,术后 1周在内膜中表达增加 ,术后 4周在内膜中大量表达 ,并可维持至 12周。结论 细胞凋亡相对不足可能是支架植入术后再狭窄形成的一个原因 ,Bcl xl在内膜中高表达可能是造成细胞凋亡相对不足的因素之一。
Objective To observe the dynamic changes of vascular endothelial cell apoptosis and expression of apoptosis related proteins after coronary artery stent implantation in dogs. Methods Fifteen dogs were implanted with left circumflex coronary stents. The corresponding vessels of the anterior descending artery were used as control. The dogs were sacrificed at 1 week, 4 weeks and 12 weeks after operation. Pathological examination was performed. Apoptosis was detected by TUNEL and transmission electron microscopy Cell, PCNA and Bcl xl immunohistochemical staining and Bcl xl Western blotting. Results Within 1 to 12 weeks after stent implantation, the area of the intima continued to increase. There were no apoptotic cells and PCNA positive cells in normal vessels. The apoptotic cells and PCNA positive cells reached the peak at 1 week after operation After 4 weeks and 12 weeks, the positive rate of apoptotic cells was lower than that of PCNA positive cells at all time points. Bcl-xl immunohistochemical staining and western blot showed that the expression of PCNA was detected in normal control group, Expressed in the endometrium increased 4 weeks after the endometrial mass expression, and can be maintained to 12 weeks. Conclusion The relative lack of apoptosis may be one of the reasons for the formation of restenosis after stent implantation. The high expression of Bcl xl in the intima may be one of the factors leading to the relative lack of apoptosis.