Fogarty球囊导管取栓对兔静脉内皮形态及血管性血友病因子表达的影响

Effects of Fogarty Balloon Catheter Thrombectomy on Rabbit Venous Endothelial Morphology and Expression of vWF

目的:观察Fogarty球囊导管取栓治疗兔急性静脉血栓后,兔病变段静脉内皮细胞形态及血管性血友病因子(vWF)的变化情况。方法:家兔95只,70只建血栓模型,并分为取栓(thrombectomy,TX)组、非取栓(non-thrombectomy,N-TX)组各35只;另25只为假手术组(shamoperation,SH)。于取栓后不同时段,获取病变段血管。扫描电镜观察内皮细胞形态学变化,免疫组化观察vWF的改变情况。结果:TX组术后1天内皮损伤为Ⅰ～Ⅱ级,4、7天时Ⅲ～Ⅳ级,14～28天Ⅱ～Ⅲ级,与N-TX和SH组比较,内皮细胞损伤重(P<0.05);vWF表达在取栓后7天时最强,14～28天有所降低。结论:急性深静脉血栓取栓后早期(7天内),静脉内皮形态学上损伤较为严重,促血小板聚集增强;取栓后期(14～28天)内皮形态部分修复,促血小板聚集有所减弱,但均未恢复到正常水平。

Objective：To experiments were designed to evaluate the effects of Fogarty balloon catheter thrombectomy on venous endothelial morphology and expression of yon willebrand factor（vWF） after acute deep venous thrombosis（DVT） in rabbit veins. Methods： The posterior vena cava under renal veins of 70 adult rabbits were ligated for 48 hours to induce thrombosis model. There thrombosed veins were separated to two group; thrombectomy（TX, n = 35） and non - thrombectomy（ N - TX, n = 35）. Sham opera- tion（ SH, n = 25 ） were used as controls. In different periods after the treatment, the structural integrity of the endothelial layer was assessed by means of scanning electron microscopy, vWF expressed by endothelial cells were detemained with immunohistochenistry. Results：Scannin electron microscopy results showed that the endothelium injury degree of TX group was mainly Ⅲ～Ⅳ grade in 4 ～ 7 days, and Ⅱ～Ⅲ grade in 14 - 28 day, and more injury compared with group N - TX and SH（ P 〈 0.05）. Expression of vWF in TX group increased in one week（peak at day 7） after the treatment and decreased gradually after 14～28 days. Conclusion： The structural and functional integrity of venous endothelium were injured severely in early period of Fogarty balloon catheter thrombectomy（ 7 day）. However, they had a partial rapair in late period（ 14 ～ 28 day）, but still abnormal.