文章摘要
邱志兵,陈 鑫,万 松.血管外膜和平滑肌细胞增殖活性及胶原分布对血管重塑影响[J].南京医科大学学报,2008,28(6):752~757
血管外膜和平滑肌细胞增殖活性及胶原分布对血管重塑影响
Effects of vascular adventitia and smooth muscle cells proliferation and collagen distribution on vascular remodeling
投稿时间:2007-12-09  
DOI:10.7655
中文关键词: 血管外膜  细胞增殖  胶原  血管重塑  再狭窄
英文关键词: vascular adventitia  cell proliferation  collagen  vascular remodeling  restenosis
基金项目:
作者单位
邱志兵 南京医科大学附属南京第一医院心胸外科,江苏 南京 210006 
陈 鑫 南京医科大学附属南京第一医院心胸外科,江苏 南京 210006 
万 松 香港中文大学威尔斯亲王医院心胸外科,香港 
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中文摘要:
      目的:动态观察静脉桥再狭窄动物模型中血管外膜和平滑肌细胞增殖活性以及胶原分布的变化,以评价血管外膜及细胞增殖和胶原分布对血管重塑的影响?方法:建立猪静脉桥再狭窄模型,采用血管病理形态学和免疫组化方法,结合Masson染色,观察术后7?30?45天血管重塑?外膜细胞和平滑肌细胞增生指数及胶原的动态变化?结果: ①术后7天新生内膜形成逐渐增厚,于术后45天达最大,外膜厚度和细胞密度于术后7天起逐渐增大,术后30天达最高,术后45天较30天相对减少(P < 0.05);PCNA染色显示,血管外膜细胞和平滑肌细胞增生指数7天显著增加,术后30天PCNA阳性表达达到高峰,45天回到基线水准;②术后7天血管外膜和内膜中胶原增多,术后30~45天见新内膜中含大量胶原,呈进行性增多趋势;血管外膜中胶原术后30天达高峰,而术后45天胶原含量下降,并见局部纤维化;③管腔面积和IELA于术后7天逐渐减小,术后30~45天管腔面积明显小于对照组,术后45天管腔面积最小(P < 0.05);剩余狭窄率与管腔面积相反,于术后7天出现逐渐增大,术后45天达最大;重塑指数和EELA术后7天稍有增大,其后不断减小,术后30~45天明显减小(P < 0.05)?结论:血管外膜细胞和平滑肌细胞的增殖活性改变以及外膜的增厚?纤维化和胶原的重排对内膜增生和血管重塑起着重要作用,参与并促进了血管桥再狭窄的发生过程?
英文摘要:
      Objective:To investigate the dynamic changes of vascular adventitia and smooth muscle cell(SMC) proliferation and collagen distribution in the vein graft restenosis model. To evaluate the effects of adventitia,cell proliferation and collagen distribution on vascular remodeling. Methods:The pig autogenous vein grafts restenosis model was constructed. Specimens were harvested at three time points that was 7th,30th and 45th days. According to the Masson staining slices,the vascular remodeling,proliferation index of adventitia cell and SMC,and collagen distribution were investigated by histomorphometrical and immunohistochemical approach. Results:①At 7thd after operation,the neointima formed and continuously thickened,whose thickness reached maximal at 45thd after operation. The thickness and cell density of adventitia increased gradually at 7thd,which reached peak at 30thd after operation. But in the 45thd group,they were smaller than those in the 30thd group. According to PCNA stain,the proliferation index of adventitia cell and SMC increased significantly at 7 d after operation,which reached peak at 30thd,whereas the expression of PCNA reverted toward the baseline at 45thd after operation. ②At 7thd after operation,the collagen of adventitia and neointima gradually increased,which of neointima at the 30th and 45thd group increased more significantly than the control and 7thd group(P < 0.05). The collagen of adventitia reached maximal at 30thd,but at 45thd,they were smaller than those at 30thd after operation(P < 0.05). ③ The luminal area and internal elastic lamina gradually decreased after operation,which in the 30thd and 45thd group reduced significantly compared with the control group and 7thd group(P < 0.05). But the residual restenosis rate changed inversely compared with the luminal area. Remodeling index and external elastic lamina slightly increased at the 7thd group,but reduced gradually after that,which in the 30thd and 45thd group decreased significantly(P < 0.05). Conclusion:The changes of vascular adventitia and smooth muscle cell proliferation,the thickness and fibration of adventitia and rearrangement of collagen are the important factors on intimal hyperplasia and vascular remodeling,which takes part in and accelerate the course of vein restenosis.
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