兔颈动脉内膜切除术后再狭窄的免疫组织化学研究

Immunohistochemical Study on the Restenosis after Carotid Endarterectomy in Rabbits Model

目的:了解颈动脉内膜切除术后新生内膜和再狭窄形成的过程及其细胞来源。方法:运用免疫组化方法,对30只日本大耳白兔颈动脉内膜切除术后再狭窄模型的标本进行分析,分别进行了增殖细胞核抗原(PCNA)、肌动蛋白(α-actin)、血小板源性生长因子(PDGF)和血小板源性生长因子受体(PDGF-R)表达的分析。结果:所有实验组,均可以见到内膜增生和再狭窄形成。PCNA在切除术后60d内有高表达,α-actin和PDGF在30d内有高表达,而PDGF-R在各时间段均无高表达。结论:新生内膜形成是由于平滑肌细胞激活后,增殖、迁移和表型转化的结果,在内膜切除术后早期(60d内)平滑肌细胞的激活与PDGF等细胞因子有关,在晚期(90d)可能与炎性细胞浸润或泡沫细胞形成有关。

Objective： To investigate the mechanism of neointimal formation and restenosis and its cell resource after carotid endarterectomy. Methods： The carotid arteries from thirty Japanese white rabbits whose carotid endarterectomy was performed were studied by the immunohistochemical stain then the expression of PCNA, α-actine, PDGF and PDGF-R was checked respectively. Results： All the operated samples showed that the neointimal formation and restenosis were appeared. PCNA was highly expressed during sixty days after operation. PDGF and α-actine were highly expressed within thirty days after operation but PDC, F-R had no any significant shift during every stage. Conclusion： The neointimal formation is formed by the actived vessel smooth muscle cells （SMC） which are proliferated, migrated and transphenotypic. The activation of the SMC is related to the PDGF and other cytokins in the early stage （sixty days） while it is related to the infiltrating inflammation cells and foam cell formation in the late stage（ninety days）.