纤维蛋白生物胶外周支持对大鼠颈静脉移植物的增殖和凋亡的影响

The Effect of the Fibrin Glue Perivenous Support on the Prolifelation and Apoptosis of the Vascular Smooth Muscle Cells

目的研究纤维蛋白胶血管外周支持对静脉移植物平滑肌细胞增殖、凋亡的影响。方法建立大鼠颈总动脉自体颈静脉移植模型,按照有无纤维蛋白胶血管外周支持,分为外周支持组、无外周支持组,每组24只。术后1周、2周、4周分别切除移植静脉,用免疫组织化学方法检测静脉移植物平滑肌细胞增殖细胞核抗原(PCNA)表达,用原位DNA断裂位点3’-羟基末端标记(TUNEL)法检测静脉移植物平滑肌细胞凋亡的变化,以及检测内膜厚度。结果静脉移植术后1-4周,无外周支持组静脉移植物血管平滑肌细胞的凋亡和增殖均明显升高,内膜明显增厚;纤维蛋白胶血管外周支持组静脉移植物血管平滑肌细胞的凋亡和增殖同处于低水平,内膜增厚不明显。两组静脉移植物血管平滑肌细胞的凋亡和增殖具有显著相关性。结论纤维蛋白胶外周支持可以抑制血管平滑肌的增殖和凋亡,使两者同时处于低水平,一方面减少细胞凋不足所造成的对血管重塑造成的影响,另一方面使凋亡程度与巨噬细胞及正常血管平滑肌吞噬作用达到平衡,抑制了静脉移植物的内膜增生。

Objectives To study the effect of the fibrin glue perivenous support on the prolifetation and apoptosis of the vascular smooth muscle cells （VSMC） in a rat model of arteriovenous bypass grafting. Methods Rat jugular vein grafting models made by transplanting autologous external jugular vein graft into the carotid artery in 48 rats, were divided into FS group （ with the fibrin glue supported vein grafts ） , NS group （without perivenous supported vein grafts）. The vein grafts were harvested in the first week, the seeond week and the fourth week after operation respectively. Terminal transferase-mediated dUTP nick end labeling （ TUNEL）, proliferating cell nuclear antigen （PCNA） stains, electron microscopy were used to assess the apoptosis and proliferation of the vascular smooth muscle cells. The thickness of neointima and media in the vein grafts was calculated by computer image analysis system. Results In FS group, apoptesis and proliferation of the vascular smooth muscle cells maintained a gradual augment. The thickness of neointima and media in the vein graft in FS group kept mildly increasing. In NS group, the apoptosis and proliferation of the vascular smooth muscle cells abnormally jumped. The thickness of neointima and media in the vein graft in NS group surpassed FS group significantly （P 〈0.001 ）, showing a rapid increase. Conclusions The fibrin glue can restrain abnormal raise of apoptosis and proliferation of the vascular smooth muscle cells so that might prevent vein graft from early intimal hyperplasia after operation.