辛伐他汀未能改善5/6肾切除大鼠自体动静脉内瘘血管内膜增生

Simvastatin Therapy is not Associated with Improved Autogenous Internal Arteriovenous Fistula in Neointimal Hyperplasis on 5/6 Nephrectomy Rats Outcomes

目的:观察辛伐他汀对5/6肾切除大鼠自体移植静脉内膜增生的影响,探讨其防治透析内瘘内膜增生是否有潜在的价值。方法:36只大鼠随机分为3组:假手术组、CRF对照组和CRF他汀组各12只。各组在成模后分别于第7天、28天各处死6只,抽血行肾功能、血脂检测,并取其内瘘内膜组织行组织病理学检查。比较相同时间点各组肾功能,血脂及内膜增生程度。结果:(1)肾功能和血脂:与同一时点假手术组相比,CRF对照组、CRF他汀组造模后第7、28天后的肌酐和尿素氮均显著增高(P<0.05),各组血脂无显著差异。(2)新生内膜面积、厚度测定:术后第7天,已见各组内瘘血管内膜受损、薄层新生内膜形成;第28天病理改变更明显。与假手术组相比,CRF对照组、CRF他汀组两组内膜增生更为明显(P<0.05);CRF对照和CRF他汀两组之间比较差异无统计学意义(P>0.05)。(3)免疫组化α-SMA、PCNA:假手术组与CRF对照组、假手术组与CRF他汀组比较差异均有统计学意义(P<0.05);CRF对照组与CRF他汀组之间差异无统计学意义(P>0.05)。结论:辛伐他汀未能改善慢性肾功能不全自体动静脉内瘘大鼠的血管内膜增生。

Objective：To investigate the effectness of simvastatin on neointimal hyperplasis of autogenous internal arteriove- nous fistula in rats model with chronic renal failure by 5/6 nephreetomy. Methods：36 rats were randomly divided into three groups： sham group, CRF control group and CRF statin group of 12 each . CRF models were made by 5/6 nephrectomy and then followed by end - to - end anastomosis of the right carotid artery and internal jugular vein. After the operation for 7 and 28 days, rats were sacri- riced, and the blood sample was taken for renal funtion and lipids, also the vein near the anastomosis site were examined for histologi- cal changes after staining with HE, combined staining for elastic and collagen rihem, and immunohistochemieal staining for alpha SMA and PCNA. Results： （ 1 ） Renal function and ]ipids ： Blood creatinine and BUN levels were significantly increased in the CRF control group and CRF statin group than sham group（ P 〈 0.05 ） , but the level of blood lipids was similar in all three groups. （2）the degree of neointimal hyperplasia： The results showed that vein tissue near anastomotic stoma occured generous VSMC and collagen fiber pro- liferation ,neointimal hyperplasia after operation, the CRF control and CRF statin groups were significantly increased compared to sham group （ P 〈 0.05 ）, the results were similar for CRF group versus CRF statin group （ P 〉 0.05 ）. （ 3 ） Immunohistochemisty re- suits showed that alpha SMA, PCNA were significantly increased in CRF control and CRF statin groups compared to sham group （P 〈 0.05 ）, but bad no statistically significant between CRF control group and CRF statin group （ P 〉 0.05 ）. Conclusion： Simvastatin therapy is not associated with improved autogenous internal arteriovenous fistula in neointimal hyperplasis on 5/6 Nephrectomy rats outcomes.