CAJ | 학술논문

目的观察术后放疗对犬下腔静脉人工血管置换术后人工血管内膜的影响.方法犬16只完全随机法分为对照组(n=8)和放疗组(n=8),均行下腔静脉膨体聚四氟乙烯(ePTFE)人工血管置换术.放疗组于术后第2N行体外35 Gy放疗,对照组术后不予放疗.2N犬均于术后第8N采集标本,观察人工血管通畅率,并行HE染色、人工血管内膜厚度测量,增殖细胞核抗原(PCNA)及CD34免疫组化检测,计算人工血管内膜100μm内皮细胞数.结果术后第8周,放疗组人工血管通畅率为100%(8/8),对照组为75%(6/8).放疗组各段人工血管内膜厚度较对照组明显减少[近心端:(610.69±32.90)μm比(753.39+10.36)μm,中段:(530.51±32.14)μm比(636.55±20.23)μm,远心端:(544.52±41.99)μm比(710.39±30.92)μm,均P＜0.01].放疗组各段人工血管内膜的PCNA阳性细胞百分率较对照组减低[近心端:(45.1±7.5)%比(56.3±7.8)%,中段:(29.2±4.1)%比(36.6±4.9)%,远心端:(33.8±5.5)%比(40.7±6.7)%,均P＜0.05].2组人工血管内膜100μm内皮细胞数的比较差异无统计学意义(P＞0.05).结论下腔静脉人工血管术置换后35 Gy体外放疗不影响移植人工血管通畅率,对内膜血管平滑肌细胞的覆盖亦无明显影响,但可抑制人工血管内膜增生和PCNA的表达.
목적 관찰술후방료대견하강정맥인공혈관치환술후인공혈관내막적영향.방법 견16지완전수궤법분위대조조(n=8)화방료조(n=8),균행하강정맥팽체취사불을희(ePTFE)인공혈관치환술.방료조우술후제2N행체외35 Gy방료,대조조술후불여방료.2N견균우술후제8N채집표본,관찰인공혈관통창솔,병행HE염색、인공혈관내막후도측량,증식세포핵항원(PCNA)급CD34면역조화검측,계산인공혈관내막100μm내피세포수.결과 술후제8주,방료조인공혈관통창솔위100%(8/8),대조조위75%(6/8).방료조각단인공혈관내막후도교대조조명현감소[근심단:(610.69±32.90)μm비(753.39+10.36)μm,중단:(530.51±32.14)μm비(636.55±20.23)μm,원심단:(544.52±41.99)μm비(710.39±30.92)μm,균P＜0.01].방료조각단인공혈관내막적PCNA양성세포백분솔교대조조감저[근심단:(45.1±7.5)%비(56.3±7.8)%,중단:(29.2±4.1)%비(36.6±4.9)%,원심단:(33.8±5.5)%비(40.7±6.7)%,균P＜0.05].2조인공혈관내막100μm내피세포수적비교차이무통계학의의(P＞0.05).결론 하강정맥인공혈관술치환후35 Gy체외방료불영향이식인공혈관통창솔,대내막혈관평활기세포적복개역무명현영향,단가억제인공혈관내막증생화PCNA적표체.
Objective To investigate the effects of postoperative irradiation on the neointima of artificial blood vessel after prosthetic vessel replacement of inferior vena cava in dogs.Methods Sixteen dogs underwent ePTFE (expended poly-tetra fluoroethylene) prosthetic vessel replacement of inferior vena cava and were then randomly divided into radiotherapy group and control group (n=8 each).For the radiotherapy group, external radiation (35 Gy) was given at two weeks after surgery.Samples were then collected from these two groups on week 8 for study of patency rate of the artificial blood vessel.In addition,HE staining, measurement of neointima thickness, PCNA (proliferating cell nuclear antigen) and CD34 stained immunohistochemistry were performed, and number of endothelial cells (ECs) within 100 Jim neointima were counted.Results The patency rate was 100% (8/8) in radiotherapy group and 75% (6/8)in control group on week 8.The neointima thickness at each segment of artificial blood vessel was significantly decreased in radiotherapy group compared with those in the control group [proximal segment:(610.69±32.90)μm vs(753.39±10.36)μm; mid segment: (530.51 ±32.14 )jun vs(636.55?0.23)μm; distal segment: (544.52±41.99)μm vs (710.39±30.92)μm, all P＜0.01].The percentage counts of PCNA positive cells in each segment of artificial blood vessel were lowered in the radiotherapy group compared with those in the control group [proximal segment: (45.1±7.5)% vs(56.3±7.8)% ; mid segment: (29.2 ±±4.1)% vs(36.6±4.9)%; distal segment: (33.8±5.5)% vs (40.76±.7)%, all P＜0.05].There was no statistical difference in number of ECs within 100 p,m neointima between two groups (P>0.05).Conclusion External radiation (35 Gy) after prosthetic vessel replacement of inferior vena cava has no significant impact on the patency of artificial blood vessel, nor on linings of vascular smooth muscle cells in neointima, but may inhibit the neointima proliferation and PCNA expression.