兔颈静脉动脉化后血管的重塑机制.doc

兔颈静脉动脉化后血管的重塑机制

作者：陶登顺，王辉山，汪曾炜，朱洪玉，高文根，王建生，

杨丽君

【关键词】 静脉移植；细胞凋亡；模型,动物

Mechanism of vascular remodeling after rabbit jugular

vein graft arterialization

【Abstract】 AIM: To establish a rabbit model of carotid

arterial venous bridge bypass graft and observe the pathological

change of the vein bridge at different phases, to detect the

expressions of PCNA and a actin, cell apoptosis, and to

investigate the mechanism of vein graft remodeling. METHODS: The

common carotid artery and external jugular vein of 30 rabbits

were dissociated and anastomosed side by side, so that arterial

blood went through external jugular vein bridge. Vein bridges

get at different time points after operation were analyzed

quantitatively in regard to the thickness of intima and media,

and observed in the expressions of PCNA and aactin and cell

apoptosis. RESULTS: All rabbits survived. The vein bridge kept

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smooth. The intima and media proliferated obviously. The wall

of vein graft thickened, but the intima proliferated unequally,

to the peak in 2 4 weeks. The expression of PCNA occurred in both

intima and media, while the expression of aactin occurred only

in intima. Cell apoptosis occurred 1 week after operation in

intima and media and peaked until 4 weeks. CONCLUSION: Rabbit

jugular vein after carotid arterial venous bridge bypass graft

showed an unirregular increase in the wall thickness.

Proliferation occurred at the early stage mainly in intima.

Proliferation of smooth muscle cells in media and their

migration into intima , cell apoptosis may all participate in

vein graft remodeling.

【Keywords】 venous graft; apoptosis; models, animal

【摘要】 目的： 建立兔颈动脉静脉桥旁路移植模型，观察

不同时期静脉桥病理改变及 PCNA，aactin 表达和检测细胞凋亡，探

讨移植静脉重塑机制. 方法： 家兔 30 只，将一侧颈总动脉与颈外静

脉分别游离后，行颈总动脉与颈外静脉侧侧吻合，结扎颈外静脉两吻

合口外侧及颈总动脉吻合口中部，使动脉血经颈外静脉桥通过，于术

后不同时间段取静脉桥行 HE 及弹力纤维染色，定量分析血管壁内膜、

中膜厚度，观察 PCNA，aactin 表达和细胞凋亡情况. 结果： 30 只

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家兔全部存活，静脉桥全部保持通畅；病理所见静脉桥血管壁增厚、

血管内膜及中膜均明显增生，术后 2~4 wk 内膜增生达高峰，且厚度不

均匀，中膜、内膜均有 PCNA 阳性表达，内膜出现aactin 阳性表达，

术后 1 wk 血管内膜及中膜开始出现凋亡细胞，术后 4 wk 达高峰. 结

论： 兔颈静脉动脉化后静脉血管管壁呈不均一性增厚，早期以血管内

膜增生为主，中膜血管平滑肌细胞增殖并向内膜迁移，细胞凋亡可能

参与血管桥重塑.

【关键词】 静脉移植；细胞凋亡；模型，动物

0 引言

静脉血管作为血管桥材料在冠状动脉旁路移植术中具有重要

作用，但血管的再狭窄一直是困扰静脉移植的难题，影响冠状动脉旁

路移植术的近远期疗效. 为了研究静脉血管动脉化后的改变，我们建

立了兔颈动脉静脉旁路移植模型，对静脉血管移植于动脉后不同时间

段的病理改变进行观察，通过血管壁 PCNA, aactin 表达和细胞凋亡

的检测，初步探讨静脉血管重塑的机制.

1 材料和方法

1.1 材料健康家兔 36 只由沈阳军区总医院动物实验外科提

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