^(32)P液体球囊防治颈动脉术后再狭窄的实验研究

Experimental study of ^(32)P liquid filled balloon catheter prevents restenosis in rabbits following carotid endarterectomy

目的 :通过3 2 P液体球囊防治颈动脉内膜剥脱术 (CEA)后再狭窄 (RS) ,动态观察内放射对中膜平滑肌细胞 (SMC)的影响 ,初步探讨其防治再狭窄的可能机制。方法 :4 0只兔CEA后 ,随机分为 4组 ,分别给予 0、10Gy、2 0Gy、4 0Gy放射剂量 (3 2 P) ,术后 3,7,14 ,2 8,5 6d分别处死动物 ,观察不同时间点不同剂量对颈动脉内膜厚度及SMC凋亡PCNA的影响。结果 :术后兔血管内、中膜厚度呈递增趋势 ,其中以 14d后增加尤其显著 ,各治疗组与照射组相比 ,除术后 3、7d外差异皆有统计学意义 (P <0 0 5 ) ;对照组与各照射组的凋亡率和PCNA阳性细胞均于术后 3d增加 ,7d时达高峰 ,差异有统计学意义 (P <0 0 1)。结论 :内放射治疗可能是通过抑制SMC增殖、迁移 ,诱导SMC凋亡 ,防治RS ,并且随剂量呈递增效应 ;球囊损伤后早期以细胞增生和凋亡为主要表现 。

Objective: To find the possible mechanisms of ^(32)P liquid filled balloon catheter in the prevention of restenosis (RS) in rabbits following carotid endarterectomy (CEA) and to observe the effects of internal radiation to medial smooth muscle cell(SMC).Methods: Forty rabbits following CEA were randomly divided into four groups (each n=10) and given a radiation dose of 0,10,20,40Gy(^(32)P) respectively.Rabbits were killed 3,7,14,28,56 days after operation.The target segments were cut down and histopathologic analysis was conducted.Results: Neointimal thickness and medial thickness of carotid artery increased gradually,especially evidently two weeks after operation.The difference were significant in endovascular radiation(ER) groups compared with control groups except 3 and 7 day (P<0 05).The expressions of PCNA and apoptosis were increased 3 days after operation and reached the peak at 7 days.There were significant difference in ER groups compared to control groups(P<0 01).Conclusion:ER may prevent RS by inhibiting SMC proliferation and migration,mean while inducing SMC apop-[FK(W5。142mmZQ1mm]tosis preventing RS.The effects were related to the delivered dose.SMC proliferation and apoptosis were revealed in the early period after balloon injury,while neontimal thickness and medial thickness were showed later.