用自体心包行静脉周支持对静脉移植物内膜增生的影响

Perivenous support with autologous pericardium inhibits neointimal thickening in canine vein grafts

目的探讨自体心包外周支持对静脉移植物内膜增生的影响。方法取犬一侧颈外静脉,对半剪成两段后分别吻合在双侧股动脉上,其中一侧静脉移植物外包裹自体心包(实验组),另一侧为单纯的静脉移植(对照组)。术后2、4周分别切除移植静脉,计算机图像分析系统测量和计算内膜厚度、内膜面积,进行扫描电镜检查,用免疫组织化学方法检测静脉移植物平滑肌增殖细胞核抗原(PCNA)的表达。结果实验组静脉移植术后2、4周内膜厚度和内膜截面积明显低于对照组(P<0.01)。实验组静脉移植物术后2、4周的PCNA指数也明显低于对照组(P<0.01;P<0.05)。扫描电镜检查显示实验组静脉移植物内皮层破坏程度轻于对照组。结论自体心包外周支持能抑制静脉移植物内膜的增生。

Objective To observe the effect of perivenous support with autologous pericardium on neointimal thickening in eanine vein grafts. Methods An autologous pericardium graft of 7 crux4 cm was harvested in right anterolateral thoracotomy. Two equal segments of the jugular vein were transplanted to both sides of the femoral arteries in 12 dogs, and on one side of the vein graft, perivenous support with autologous pericardium was applied. The vein grafts were harvested 2 and 4 weeks after operation and the thickness and area of the neointima calculated using computerized image analysis system. Scanning electron microscopy and PCNA immunohistochemistry were also performed. Results The thickness and area of the neointima were significantly greater in the control gratis than in the grafts with perivenous support （P〈0.05）, and the proliferation of vascular smooth muscle cells in the supported graft was less active （P〈0.05）. Electron microscopy showed extensive destruction of the endothelium in the control graft, hut only slight damage was found in the graft with perivenous support. Conclusion Perivenous support of the vein graft with autologous pericardium can reduce intimal and medial hyperplasia in the graft.