CAJ | 학술논문

目的研究血管成型术后降脂药物抑制动脉再狭窄形成的作用及其作用机制. 方法应用球囊导管对家兔主动脉,髂及股动脉造成去内膜损伤以观察使用降血脂药物simvastatin +gemfibrozil 或单一使用 simvastatin 6 星期后对内膜生长因子包括血小板源生长因子(PDGF-B),转移生长因子-1(TGF-1),碱性纤维母细胞生长因子(bFGF)以及血清总胆固醇(TC)和甘油三脂(TG)的影响.结果给予降血脂药6周的两组家兔,虽同时摄入高胆固醇但血清TC和TG(simvastatin + gemfibrozil 组)水平仅有轻度或中度升高.此外,还观察到血清TC 水平和内膜/中膜比值呈正相关 (r=0.5873,P<0.05). 免疫组化染色及RT-PCR扩增检测均显示simvastastin+gemfibrozil 可抑制去内皮手术后内膜PDGF-B的释放.RT-PCR还显示两组治疗组新生内膜内均有TGF-1表达增加.但手术组及治疗组动物受损伤动脉壁的平滑肌细胞内bFGF mRNA 无明显改变.结论降脂药simvastatin和gemfibrozil 除具有降血脂功能外,还影响去内膜手术损伤后动脉新生内膜内PDGF-B和TGF-1 的释放.
목적연구혈관성형술후강지약물억제동맥재협착형성적작용급기작용궤제. 방법응용구낭도관대가토주동맥,가급고동맥조성거내막손상이관찰사용강혈지약물simvastatin +gemfibrozil 혹단일사용 simvastatin 6 성기후대내막생장인자포괄혈소판원생장인자(PDGF-B),전이생장인자-1(TGF-1),감성섬유모세포생장인자(bFGF)이급혈청총담고순(TC)화감유삼지(TG)적영향.결과급여강혈지약6주적량조가토,수동시섭입고담고순단혈청TC화TG(simvastatin + gemfibrozil 조)수평부유경도혹중도승고.차외,환관찰도혈청TC 수평화내막/중막비치정정상관 (r=0.5873,P<0.05). 면역조화염색급RT-PCR확증검측균현시simvastastin+gemfibrozil 가억제거내피수술후내막PDGF-B적석방.RT-PCR환현시량조치료조신생내막내균유TGF-1표체증가.단수술조급치료조동물수손상동맥벽적평활기세포내bFGF mRNA 무명현개변.결론강지약simvastatin화gemfibrozil 제구유강혈지공능외,환영향거내막수술손상후동맥신생내막내PDGF-B화TGF-1 적석방.
Objective　To study the mechanism and effect of lipid lowering drugs in arresting the development of arterial restenosis after angioplasty. Methods　De-endothelialization injury of rabbit aortae, common iliac and femoral arteries using balloon angioplasty and the expression of growth factors such as platelet derived growth factor-B (PDGF-B), transforming growth factor β-1 (TGFβ-1), and fibroblast growth factos (bFGF) were investigated. Total serum cholesterol (TC) and triglycerides (TG) were analyzed during and after the treatment using either simvastatin combined with gemfibrozil or simvastatin alone for 6 weeks. Results　Serum total cholesterol and triglycerides were only slightly to moderately increased after high cholesterol ration intake lasting for 6 weeks in rabbits of two therapeutic groups (simvastatin plus gemfibrozil or only simvastatin). A positive correlation was found between TC and intimal/medial ratio (r=0.5873, P<0.05). PDGF-B detected by immuno-histochemistry and RT-PCR analysis showed that the release of PDGF-B was inhibited by simvastatin and gemfibrozil after de-endothelialization. RT-PCR analysis showed that TGFβ-1 was increased in the neointima in two treatment groups but no definite change was seen in the mRNA of bFGF in the smooth muscle cell (SMC) of the balloon-injured arteries even under lipid lowering drug treatment. Conclusion　In addition to the lipid lowering effect, both simvastatin and gemfibrozil also influence the release of PDGF-Band TGF-1 in the neointima after de-endothelialization.