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[冠状动脉搭桥术后静脉移植物内膜增生机制的实验研究]

[Mechanism of intimal hyperplasia of venous grafts after coronary artery bypass grafting, an experimental study].

作者信息

Xiao Mingdi, You Wenjun, Yuan Zhongxiang, Xu Genxing

机构信息

Department of Cardiovascular Surgery, Shanghai First People's Hospital, Shanghai 200080, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2002 Nov 25;82(22):1550-2.

Abstract

OBJECTIVE

To study the mechanism of intimal hyperplasia after coronary artery bypass grafting (CABG) and to find an effective way for preventing intimal hyperplasia.

METHODS

Twenty-four male New Zealand rabbits were randomly divided into two groups of 12 rabbits: operation group and sham-operation (control) group. The external jugular vein was harvested and anastomosed end-to-side to the ipsilateral carotid artery in operation group or grafted in situ in the control group. Six rabbits in each group were killed and their grafted veins were taken 2 weeks and 4 weeks after operation respectively. The mRNA expressions of transforming growth factor beta (TGF-beta), collagen I, collagen III, and angiotension 1 receptor (AT1R) were measured by RT-PCR and electrophoresis.

RESULTS

The intimal hyperplasia was much more remarkable in the operation group than in the control group either 2 weeks or 4 weeks after operation. The mRNA expressions of TGF-beta, AT1R, collagen I, and collagen III were significantly higher in the operation group than in the control group, especially 2 weeks after (P < 0.01). Four weeks after the operation, the expressions of TGF-beta, AT1R, collagen I and collagen III were 4.05 +/- 0.49 vs 2.05 +/- 0.26, 18.23 +/- 1.32 vs 4.61 +/- 0.53, 80 +/- 0.17 vs 0.90 +/- 0.18, and 7.05 +/- 0.68 vs 2.80 +/- 0.17 respectively (all P < 0.05).

CONCLUSION

TGF-beta and AT1R may have an important role in the intimal hyperplasia of venous graft in CABG. Continuous arterial pressure may be the main factor of increased expression of TGF-beta and AT1R that cause the enormous synthesis and deposit of collagen.

摘要

目的

研究冠状动脉旁路移植术(CABG)后内膜增生的机制,并寻找预防内膜增生的有效方法。

方法

将24只雄性新西兰兔随机分为两组,每组12只:手术组和假手术(对照)组。手术组取颈外静脉并将其与同侧颈动脉端侧吻合,对照组则将颈外静脉原位移植。每组分别于术后2周和4周处死6只兔子,并取出移植静脉。采用逆转录聚合酶链反应(RT-PCR)和电泳法检测转化生长因子β(TGF-β)、I型胶原、III型胶原和血管紧张素1受体(AT1R)的mRNA表达。

结果

术后2周和4周,手术组的内膜增生均比对照组明显得多。手术组TGF-β、AT1R、I型胶原和III型胶原的mRNA表达显著高于对照组,尤其是术后2周(P<0.01)。术后4周,TGF-β、AT1R、I型胶原和III型胶原的表达分别为4.05±0.49对2.05±0.26、18.23±1.32对4.61±0.53、80±0.17对0.90±0.18和7.05±0.68对2.80±0.17(均P<0.05)。

结论

TGF-β和AT1R可能在CABG静脉移植物内膜增生中起重要作用。持续的动脉压力可能是导致TGF-β和AT1R表达增加从而引起大量胶原合成和沉积的主要因素。

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