CAJ | 학술논문

目的探讨自体静脉外支架对动脉缺损静脉移植后内膜增生的影响.方法选用36只5月龄雄性新西兰大白兔,体质量2.8～3.0 kg,随机分为A组、B组和C组(n=12).切取右侧颈外静脉6 cm,等分为3段,远心段均用作移植静脉;B组以中段作为自体外支架,A组以近心段套叠中段做成双层自体外支架.游离左侧颈总动脉,中间切除长0.5 cm一段,建立动脉缺损模型,将移植静脉远近端倒置后吻合于动脉缺损,通血后行移植静脉外径测量.分别于术后2、4周切取移植静脉,行HE染色、Masson染色观察移植静脉管壁组织学变化,增殖性细胞核抗原免疫组化染色观察移植静脉平滑肌细胞增殖情况.结果通血后移植静脉直径A组(1.6±0.3)mm,B组(2.2±0.4)mm,C组(2.6±0.6)mm(P<0.05).术后4周移植静脉内膜增生程度和内膜细胞增殖指数分别为:A组1.01±0.07和6.84±1.98,B组1.32 4±0.08和11.01±2.61,C组1.55±0.03和14.96±4.14,均为A组<B组<C组(P<0.05).结论双层自体静脉外支架可有效地抑制移植静脉内膜增生.
목적 탐토자체정맥외지가대동맥결손정맥이식후내막증생적영향.방법 선용36지5월령웅성신서란대백토,체질량2.8～3.0 kg,수궤분위A조、B조화C조(n=12).절취우측경외정맥6 cm,등분위3단,원심단균용작이식정맥;B조이중단작위자체외지가,A조이근심단투첩중단주성쌍층자체외지가.유리좌측경총동맥,중간절제장0.5 cm일단,건립동맥결손모형,장이식정맥원근단도치후문합우동맥결손,통혈후행이식정맥외경측량.분별우술후2、4주절취이식정맥,행HE염색、Masson염색관찰이식정맥관벽조직학변화,증식성세포핵항원면역조화염색관찰이식정맥평활기세포증식정황.결과 통혈후이식정맥직경A조(1.6±0.3)mm,B조(2.2±0.4)mm,C조(2.6±0.6)mm(P<0.05).술후4주이식정맥내막증생정도화내막세포증식지수분별위:A조1.01±0.07화6.84±1.98,B조1.32 4±0.08화11.01±2.61,C조1.55±0.03화14.96±4.14,균위A조<B조<C조(P<0.05).결론 쌍층자체정맥외지가가유효지억제이식정맥내막증생.
Objective To assess the effect of the autologous venous external stents on intimal hyperplasia of the vein grafts in rabbits. Methods Thirty-six male New Zealand white rabbits, aged 5 months and weighing 2. 8 to 3. 0 kg, were randomly divided into 3 groups: group A, group B and group C, with 12 rabbits in each group. First, a section about 6 cm long of vein was cut from the right external jugular vein of each rabbit and severed to have 3 equal-length segments. Next, each distal segment prepared for anastomosis. The proximal segment invaginating middle segment in group A and only middle segment in group B were used for the external stent. later, the left common carotid artery was separated from surrounding tissue, from it a section about 0. 5 cm long was cut away. Finally, the vein graft was inverted and end-to-end anastomosed to the two ends of the artery with a 9-0 suture. After bloodstream re-established, the diameter of each vein graft was measured. At 2 and 4 weeks postoperative,the graft veins were cut off and histologically examined by the means of HE staining and Masson staining. The smooth muscle cells (SMC) proliferation was studied by the immunohistochemical detection of proliferating cell nuclear antigen. Results After bloodstream re-established, the diameters of vein graft of group A and group B and group C were (1.6 ±0.3) mm, (2. 2 ±0.4) mm and (2.6 ± 0.6) mm respectively (P < 0.05 ) .At 4 weeks postoperative, the data of the ratio of intima to media thickness and the index of the proliferating cells of the intima were as follow: group A ( 1. 01 ±0.07 and 6. 84 ± 1. 98), group B (1. 32 ± 0. 08 and 11. 01 ± 2. 61) , group C (1. 55 ±0. 03 and 14. 96 ±4. 14). Both the data of group A were obviously less than that in group B, and that of group B was less than group C ( P < 0.05). Conclusion The autologous venous two-layer external stents inhibit intimal hyperplasia of the vein gratfs.