糖尿病兔动脉损伤后内膜增生的机制

Mechanisms of Intimal Hyperplasia in Balloon Injured Iliac Artery of Diabetic Rabbit

为探讨糖尿病患者经皮腔内冠状动脉成形术后高再狭窄率的机制和L -精氨酸与维生素C对新生内膜的影响 ,将 36只糖尿病兔和 8只正常兔分为对照组、糖尿病组、L -精氨酸组、维生素C组及L -精氨酸 +维生素C组 ,球囊损伤术后 4周取髂动脉进行图像分析。结果发现 ,L -精氨酸 +维生素C组新生内膜面积明显小于糖尿病组 (0 .15 3± 0 .0 16mm2 比 0 .2 5 5± 0 .0 2 4mm2 ,P <0 .0 1) ,且其血浆丙二醛含量显著降低 ,超氧化酶歧化物和一氧化氮含量明显升高。提示L -精氨酸和维生素C合用能抑制糖尿病兔动脉损伤后的内膜增生 ,此作用可能与一氧化氮的产生及氧自由基的减少有关。

Aim To study the mechanisms of the high restenosis rate of the patients with diabetes mellitus after percutaneous transluminal coronary angioplasty (PTCA) and the influence of L-arginine (L-Arg) and vitamin C (Vit C) on intimal hyperplasia. [WT5”HZ]Methods The iliac arteries of 36 diabetic rabbits induced by alloxan and 8 normal rabbits were injured by balloon. All rabbits were divided randomly into control group, DM group, L-Arg group, Vit C group and L-Arg+Vit C group, respectively provided with normal drinking water, normal drinking water, 2.25% L-Arg solution as the drinking water, Vit C (0.25 mg/g·d), or combided L-Arg with Vit C for 5 weeks. 4 weeks after the balloon injury, all the illacs were excised to being analyzed by computer after formaldehyde-intu-perfuse. Results The neointimal area of DM group was significantly larger than that of control group (0.255±0.024 mm 2 vs 0.176±0.029 mm 2, P<0.01), however, the neointimal area of L-Arg+Vit C group was significantly reduced than that of DM group (0.153±0.016 mm 2 vs 0.255±0.024 mm 2, P<0.01), together with a significant decrease in malondialdehyde (MDA) plasma level and significant increase in both superoxide dismutase (SOD) and nitric oxide (NO) plasma levels than those of DM group. Conclusions The therapy of combining L-Arg with Vit C could reduced the neointimal hyperplasia induced by balloon injury in diabetic rabbits. It might be effective by increasing the synthesis of endothelium-derived relaxing factor (EDRF) and protecting EDRF from being quenched by oxygen free radical.