CAJ | 학술논문

目的观察血管成形术后,病变近端正常参考血管重构的发生以及与病变部位血管重构的关系,并观察了粒细胞-巨噬细胞集落刺激因子(GM-CSF)对血管重构的影响.方法健康新西兰大白兔28只随机分为GM-CSF组和单纯损伤组.GM-CSF组皮下注射GM-CSF10 μg·kg-1·d-1,单纯损伤组皮下注射同等量生理盐水.7 d后球囊扩张损伤髂动脉.分别于术前、术后4周耳缘静脉采血检测一氧化氮(NO)浓度;4周后提取损伤动脉标本,观察内膜增生情况并测定病理形态学参数.结果术后4周GM-CSF组N0浓度(98±10)μmol/L高于单纯损伤组(83±12)μLmol/L.单纯损伤组球囊损伤处血管残余管腔面积(LA)小于GM-CSF组[(0.87±0.40)mm2 vs(1.34±0.52)mm2,P＜0.05],损伤处内膜+中膜面积(I+M)大于单纯损伤组[(2.62±0.48)mm2 vs(2.26±0.43)mm2,P＜0.05],两组损伤处外弹力膜环绕面积(EELA)差异无统计学意义[(3.48±0.80)min2 vs(3.60±0.91)mm2,P＞0.05].单纯损伤组参考血管LA小于GM-CSF组[(1.60±0.48)mm2 vs(1.99±0.54)mm2,P＜0.05],两组参考血管I+M无明显差异,LA与I+M之间不存在相关性,而参考血管EELA与LA及I+M之间有明显的相关性(r=0.91,P＜0.001;r=0.685,P＜0.001).两组参考血管LA、EELA与损伤处血管LA、EELA也明显相关(r=0.919,P＜0.001;r=0.909,P＜0.001).结论血管重构不仅发生在病变血管,同时也发生在近端参考血管.GM-CSF可以促进受损内皮细胞修复,改善负性血管重构.
목적 관찰혈관성형술후,병변근단정상삼고혈관중구적발생이급여병변부위혈관중구적관계,병관찰료립세포-거서세포집락자격인자(GM-CSF)대혈관중구적영향.방법 건강신서란대백토28지수궤분위GM-CSF조화단순손상조.GM-CSF조피하주사GM-CSF10 μg·kg-1·d-1,단순손상조피하주사동등량생리염수.7 d후구낭확장손상가동맥.분별우술전、술후4주이연정맥채혈검측일양화담(NO)농도;4주후제취손상동맥표본,관찰내막증생정황병측정병리형태학삼수.결과 술후4주GM-CSF조N0농도(98±10)μmol/L고우단순손상조(83±12)μLmol/L.단순손상조구낭손상처혈관잔여관강면적(LA)소우GM-CSF조[(0.87±0.40)mm2 vs(1.34±0.52)mm2,P＜0.05],손상처내막+중막면적(I+M)대우단순손상조[(2.62±0.48)mm2 vs(2.26±0.43)mm2,P＜0.05],량조손상처외탄력막배요면적(EELA)차이무통계학의의[(3.48±0.80)min2 vs(3.60±0.91)mm2,P＞0.05].단순손상조삼고혈관LA소우GM-CSF조[(1.60±0.48)mm2 vs(1.99±0.54)mm2,P＜0.05],량조삼고혈관I+M무명현차이,LA여I+M지간불존재상관성,이삼고혈관EELA여LA급I+M지간유명현적상관성(r=0.91,P＜0.001;r=0.685,P＜0.001).량조삼고혈관LA、EELA여손상처혈관LA、EELA야명현상관(r=0.919,P＜0.001;r=0.909,P＜0.001).결론 혈관중구불부발생재병변혈관,동시야발생재근단삼고혈관.GM-CSF가이촉진수손내피세포수복,개선부성혈관중구.
Objective To observe the correlation of the arterial remodeling at the reference site and the lesion site and the effect of granulocyte-macrophage colony-stimulating factor(GM-CSF)on arterial remodeling.Methods 28 healthy New Zealand White rabbits were randomized to 2 equal groups:GM-CSF group receiving subcutaneous injection of GN-CSF(10μg·kg-1·d-1)for 7 days,and pure damage group given subcutaneous injection of equivalent normal saline foe 7 days.Seven days later the iliac arteries of all animals were damaged by balloon.The levels of nitrogen monoxide(NO)were detected before and 4 weeks after angioplasty.Histological sections of iliac from rabbits killed 4 weeks after angioplasty were analyzed.Lumen area(LA),external elastic lamina area(EELA),and intimal plus medial areas(I+M)were measured at the lesion(L) and reference(R) sites.Results The NO levels 4 weeks later of the GM-CSF group was 98±10 μmol/L,significantly higher than that of the pure damage group(83±12 μmol/L,P＜0.05).Morphometric analysis showed that the LA(L) of the pure damage group was(0.87±0.40)mm2,significantly smaller than thal of the GM-CSF group[(1.34±0.52)mm2,P＜0.05].The I+M(L) of the pure damage group was(2.62±0.48)mm2,significantly greater than that of the GM-CSF group[(2.26±0.43)mm2,P＜0.05].There was no statistical significance in the EEL(L) between the 2 groups[(3.48±0.80)mm2 versus(3.60±0.91)mm2,P＞0.05].Morphometric analysis showed that the LA(R) of the pure damage group was(1.60±0.48)mm2,significantly smaller than that of the GM-CSF group[(1.99±0.54)mm2,P＜0.05],whereas there was no statistical signiticance in the I+M(R)between the 2 groups.In both groups,LA(R).was significantly correlated with LA(L)(r=0.919,P＜0.001);and EELA(R)was significantly correlated with EELA(L)(r=0.909,P＜0.001)and I+M(R)(r=0.685;P＜0.001).Conclusion Remodeling affects both the lesion and the reference sites and appears to occur in parallel and proportionately at both sites.GM-CSF treatment increases re-endothelialization of the injured artery and inhibits unfavorable remodeling.