Timms I D, Tomaszewski J E, Shlansky-Goldberg R D
Department of Radiology, Hospital of the University of Pennsylvania, University of Pennsylvania, School of Medicine, Philadelphia 19104, USA.
J Vasc Interv Radiol. 1995 May-Jun;6(3):365-78. doi: 10.1016/s1051-0443(95)72825-1.
To determine whether intravenous administration of Astenose, a high-molecular-weight nonanticoagulant heparin, can reduce restenosis following balloon angioplasty in a rabbit model.
Focal atherosclerosis was induced in 54 rabbits (89 vessel), and angioplasty was performed after animals were randomized into five groups. Group 1 vessels (control) were treated with lactated Ringer solution for 28 days (n = 19); group 2, Astenose at 0.10 mg/kg per hour for 28 days (n = 16); group 3, Astenose at 0.33 mg/kg per hour for 28 days (n = 16); group 4, Astenose at 0.60 mg/kg per hour for 28 days (n = 17); and group 5, Astenose at 0.33 mg/kg per hour for 14 days (n = 21). Arteriograms were obtained to measure minimal luminal diameters before, immediately after, and 28 days after angioplasty, and the rabbits were killed for histologic analysis.
Angiographically demonstrated restenosis was significantly reduced in groups 3 (18.9% +/- 3.7, P = .04) and 4 (20.2% +/- 3.1, P = .04) compared with the control group (32.4% +/- 4.8). Group 5 showed a nonsignificant trend toward reduced restenosis (23.1% +/- 2.9, P = .09), and group 2 showed restenosis similar to that in group 1 (31.0% +/- 2.5, P = .80). However, quantitative histopathologic analysis detected no differences among the groups in absolute plaque area. Medial area was significantly smaller in groups 2 and 5 (P < or = .002) than in group 1, and there was a nonsignificant trend toward reduced medial area in groups 3 and 4 (P = .12).
Long-term intravenous Astenose therapy resulted in a modest but statistically significant reduction in angiographically demonstrated restenosis after angioplasty in this atherosclerotic rabbit model.
确定静脉注射高分子量非抗凝肝素阿替诺酯是否能减少兔模型球囊血管成形术后的再狭窄。
对54只兔子（89条血管）诱导形成局灶性动脉粥样硬化，将动物随机分为五组后进行血管成形术。第1组血管（对照组）用乳酸林格液治疗28天（n = 19）；第2组，以每小时0.10 mg/kg的剂量给予阿替诺酯，共28天（n = 16）；第3组，以每小时0.33 mg/kg的剂量给予阿替诺酯，共28天（n = 16）；第4组，以每小时0.60 mg/kg的剂量给予阿替诺酯，共28天（n = 17）；第5组，以每小时0.33 mg/kg的剂量给予阿替诺酯，共14天（n = 21）。在血管成形术前、术后即刻及术后28天获取血管造影片以测量最小管腔直径，并处死兔子进行组织学分析。
与对照组（32.4%±4.8）相比，第3组（18.9%±3.7，P = 0.04）和第4组（20.2%±3.1，P = 0.04）血管造影显示的再狭窄明显减少。第5组显示出再狭窄减少的趋势，但无统计学意义（23.1%±2.9，P = 0.09），第2组显示的再狭窄与第1组相似（31.0%±2.5，P = 0.80）。然而，定量组织病理学分析未发现各组在绝对斑块面积上有差异。第2组和第5组的中膜面积明显小于第1组（P≤0.002），第3组和第4组的中膜面积有减小的趋势，但无统计学意义（P = 0.12）。
在这个动脉粥样硬化兔模型中，长期静脉注射阿替诺酯治疗导致血管造影显示的血管成形术后再狭窄有适度但具有统计学意义的减少。
