早期动脉粥样硬化血管造影征象的实验研究

Experimental Study of Value of Angiography in the Diagnosis of Early Atherosclerosis

目的：探讨早期动脉粥样硬化的血管造影征象，以达到临床早期诊断、预防及治疗，材料与方法：（1）采用雄性新西兰白兔20只，每只2kg左右，均为3月龄，随机分A、B两组，A组为普通饲料喂养，作为对照组；B组用含1％胆固醇兔饲料喂养，作为高胆固醇血症、早期动脉粥样硬化模型；喂养时间均为10周；（2）10周末对兔进行股动脉造影，观察其对血管活性药物乙酰胆碱等的反应；（3）取股动脉标本进行电镜超微结构观察；（4）10周末测定两组兔血总胆固醇、甘油三酯、高密度脂蛋白水平。结果：（1）A组兔血胆固醇检测正常，股动脉造影无异常，注入乙酰胆碱，血管呈舒张性反应。（2）B组兔呈高胆固醇血症，股动脉标本电镜观察有早期动脉粥样硬化改变，股动脉造影形态无异常，注入乙酰胆碱，血管呈收缩性反应。结论：血管活性药物乙酰胆碱引起的血管收缩性反应可作为早期动脉粥样硬化诊断的一个指征，对于临床可疑动脉硬化患者血管造影未显示形态变化时，动脉内注入乙酰胆碱观察其舒缩反应，可以做为诊断早期动脉粥样硬化的方法之一。

Objective: To evaluate value of angiography in the diagnosis of early atherosclerosis. Materials and Methods: Twenty male New Zealand white rabbits were divided into two groups. Rabbits in group A were fed a standard diet, in group B were fed diet with 1% cholesterol for 10 weeks. At the end of the dietary intervention, femoral artery angiography was made before and after infusion of acetylcholine (ACH), partial femoral arterial rinds were obtained for electron microscopic examination. Results: Electron microscopy revealed adherent monocyte, lipid-deposition in the intima, subjacent media and migration of smooth muscle cell in group B. There were no these changements in group A. ACH caused vasoconstriction of femoral arteries that were angiographically normal in group B. In constrast, vasodilation in femoral arteries in group A after use of ACH were observed. Conclusion: ACH-induced vasoconstriction of angiographycally normal vessels provides an useful method to diagnose early atherosclerosis.