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血管内照射与药物联用对血管介入治疗后再狭窄的影响

Effects of intravascular irradiation plus drugs on restenosis following intravascular intervention therapy
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摘要 目的观察血管内照射、氯吡格雷和他汀类药物辛伐他汀联合应用对再狭窄的预防作用,分析这几种方法之间是否存在协同作用。方法采用雄性新西兰白兔,给予高脂高胆固醇膳食喂养6周后,行髂动脉内膜损伤术复制成再狭窄模型。然后随机分成4组:单纯损伤组、照射组、药物组、联合组。术后2,4,8周3个时相点用免疫组化方法检测血管壁增殖细胞核抗原(PCNA)表达阳性细胞,即增殖细胞;以及核因子κB(NF-κB)和细胞间黏附分子-1(ICAM-1)的表达;用计算机图像分析法观察血管组织形态学的变化,并对免疫组化结果进行定量分析。结果其他3组与单纯损伤组相比:①表示内膜增殖程度的指标如:内膜厚度(IT)、内膜/中膜厚度(IT/MT)、内膜面积(IA)、内膜面积/中膜面积(IA/MA)和管腔面积(LA)均显著减少(P<0·05);②血管壁增殖细胞PCNA及NF-κB、ICAM-1的表达均显著降低(P<0·05);联合组与其他3组相比:①表示内膜增殖程度的指标IT、IT/MT、IA、IA/MA、LA均显著减少(P<0·05);②血管壁增殖细胞PCNA及NF-κB、ICAM-1的表达均显著降低(P<0·05)。结论①抗血小板药物氯吡格雷和他汀类药物辛伐他汀联合应用可以防止再狭窄的形成;②血管内照射可有效地防止血管成形术后再狭窄的形成;③联合应用血管内照射和斯伐他汀与氯吡格雷进行干预效果更加明显。 Objective To evaluate the preventive effects of intravascular irradiation plus clopidogrel and simvastatin on restinosis, and to analyse their synergy. Methods Male New Zealand rabbit models with restenosis were developed. They were divided into 4 groups: only injuried group, intravascular irradiation group followed immediately by ionizing radiation using liquid  32P-filled balloon catheter, drug group, fed clopidogrel and simvastatin,and combined group given ionizing irradiation and fed clopidogel and simvastatin. At weeks 2, 4 and 8 after the balloon injury operation, the target vascular sections were cut and stained with HE, and analysis of photomicrograms using computer to estimate the vessl histomorphologic changes. ICAM-1, NF-κB and PCNA expression was detected by immunohistochemical technique. Results Intravascular irradiation treatment significantly inhibited neointimal proliferation. Intravascular irradiation group compared with injured group:① Lumen area(LA), intimal thickness(IT), intimal area(IA), and IT/MT and IA/MA ratios of rapamycin group were significantly reduced (P<0.05) with dose-dependent decrease(P<0.05); ②PCNA, NF-κB and ICAM-1 expression was significantly reduced(P<0.05) with dose-dependent decrease(P<0.05). Other three group compared with combined group:① LA, IT, IA, IT/MT and IA/MA of the combined group were significantly reduced (P<0.05) with dose-dependent decrease(P<0.05); ②PCNA, NF-κB and ICAM-1 expression was significantly reduced(P<0.05) with dose-dependent decrease(P<0.05). Conclusion ①Clopidogrel and simvastatin can prevent restenosis.②Intravascular irradiation can prevent restenosis.③The effect of intravascular irradiation with clopidogrel and simvastatin is better than only intravascular irradiation
出处 《山西医科大学学报》 CAS 2005年第3期288-291,共4页 Journal of Shanxi Medical University
关键词 缩窄 病理性 照射 血管内 辛伐他汀 氯吡格雷 增殖细胞核抗原 胞间黏附分子-1 constriction,pathologic irradiation,intravascular simvastitin clopidogrel proliferation cell nuclear antigen intercellular adhesion molecule-1 rabbits
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参考文献16

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