CAJ | 학술논문

目的通过比较糖尿病及非糖尿病冠状动脉旁路移植术(CABG)患者的桡动脉形态学及血管内皮生长因子(VEGF)表达水平的变化,评价糖尿病患者桡动脉的质量及影响其CABG远期通畅率的可能因素.方法利用前瞻性分析的方法对2009年6月至2010年12月20例糖尿病组及20例非糖尿病组CABG患者的桡动脉形态学进行观察,利用HE染色对比两组患者桡动脉的内膜增厚情况,并通过Western blot法及免疫荧光对两组患者桡动脉中VEGF表达量及定位情况进行比较.结果糖尿病组桡动脉内皮增厚指数及内膜/中膜比高于非糖尿病组,分别为0.90±0.28比0.29±0.25(t =7.27,P＜0.01)及0.90 ±0.21比0.37 ±0.18(t=8.57,P＜0.01).糖尿病组桡动脉VEGF表达水平明显高于非糖尿病组,其与内参照的灰度值比值为1.20 ±0.21比0.67 ±0.15(t =6.49,P＜0.01),主要定位于糖尿病组患者桡动脉内皮细胞的细胞质中.结论糖尿病患者桡动脉内膜层厚度明显高于非糖尿病患者,VEGF可能与糖尿病组患者桡动脉内膜层增厚有关.糖尿病患者应慎重选择桡动脉作为CABG桥血管.
목적 통과비교당뇨병급비당뇨병관상동맥방로이식술(CABG)환자적뇨동맥형태학급혈관내피생장인자(VEGF)표체수평적변화,평개당뇨병환자뇨동맥적질량급영향기CABG원기통창솔적가능인소.방법 이용전첨성분석적방법대2009년6월지2010년12월20례당뇨병조급20례비당뇨병조CABG환자적뇨동맥형태학진행관찰,이용HE염색대비량조환자뇨동맥적내막증후정황,병통과Western blot법급면역형광대량조환자뇨동맥중VEGF표체량급정위정황진행비교.결과 당뇨병조뇨동맥내피증후지수급내막/중막비고우비당뇨병조,분별위0.90±0.28비0.29±0.25(t =7.27,P＜0.01)급0.90 ±0.21비0.37 ±0.18(t=8.57,P＜0.01).당뇨병조뇨동맥VEGF표체수평명현고우비당뇨병조,기여내삼조적회도치비치위1.20 ±0.21비0.67 ±0.15(t =6.49,P＜0.01),주요정위우당뇨병조환자뇨동맥내피세포적세포질중.결론 당뇨병환자뇨동맥내막층후도명현고우비당뇨병환자,VEGF가능여당뇨병조환자뇨동맥내막층증후유관.당뇨병환자응신중선택뇨동맥작위CABG교혈관.
Objective To evaluate the quality of the radial artery for coronary artery bypass grafting (CABG) from patients with diabetes by observing the morphology of the radial artery and detecting the expression of vascular endothelial growth factor (VEGF) which may attribute to the long-term patency rate of the coronary artery bypass grafting.Methods Samples from 20 cases of diabetic and non-diabetic patients were prospective collected from June 2009 to December 2010.HE staining technique was used to test the morphology of radial artery through the observation of 20 cases of diabetic and 20 cases of non-diabetic patients who undergone CABG.The intimal thicken of the radial artery in the two groups of patients was compared.Western blot and immunofluorescence were then used to test the expression and location of VEGF in the two groups of patients.Results The radial artery endothelial thickening index and intima/media ratio were significantly higher in the diabetic patients when compared with non-diabetic patients (0.90 ±0.28 vs.0.29±0.25,t=7.27,P＜0.01; 0.90±0.21 vs.0.37±0.18,t=8.57,P＜0.01).The expression of VEGF in diabetic patients was significantly higher than non-diabetic patients as revealed by Western blot (1.20 ±0.21 vs.0.67 ±0.15,t =6.49,P ＜0.01).Immunofluorescence showed that VEGF distributed in the cytoplasm of the endothelial cells of diabetic patients radial artery.Conclusions Diabetic patient's radial artery intimal thickness is significantly higher than non-diabetic patient's.VEGF may be an important inflammatory cytokine which is leading the radial artery intima thickening in the diabetic patients.The choice of the radial artery grafts in diabetic patients for CABG should be careful.