增加血流动力学导致基底动脉重构的形态学及病理学早期观察

Early morphology and pathology of the basilar artery remodeling induced by hemodynamic changes

目的 探讨基底动脉血流动力学改变后基底动脉形态及病理变化.方法 新西兰大白兔双侧颈总动脉结扎以代偿性增加椎基底动脉血流,分别于术前及术后1d、1周、2周经颅多普勒检测基底动脉血流速度;术后1周、2周分别行脑血管造影,并且测量基底动脉直径及迂曲程度;对基底动脉病理切片EVG、Masson染色分析.结果 颈总动脉结扎后基底动脉血流明显增快（10.99 ml/min对比36.53 ml/min,P＜0.001）,术后1周、2周基底动脉直径增大（0.60 mm对比0.82 mm;0.73 mm对比1.03 mm,P＜0.001）,内弹力层完整,平滑肌层增生;并且迂曲成角,57.1％基底动脉向左侧弯曲,较术前差异有统计学意义（P＜0.05）.结论 基底动脉血流动力学增加是导致基底动脉迂曲成角的主要原因.

Objective To explore the basilar artery morphology and pathology after hemodynamic changes of basilar-artery.Methods New Zealand white rabbits were subjected to bilateral common carotid artery ligafion to produce compensatory vertebrobasilar artery flow increase.The basilar artery flow velocity was monitored by transcranial Doppler before the procedure and at 1 day,1 week and 2 weeks after the procedure.DSA was performed at 1 week and 2 weeks after the procedure respectively and the basilar artery diameter and the extent of toauosity were measured.The basilar artery tissues were harvested at 1 week and 2 weeks after the procedure and examined histologically by EVG and Masson staining.Results The basilar artery flow velocity of New Zealand white rabbit was increased significantly subjected to common carotid artery ligation （10.99 ml/min vs 36.53 ml/min,P 〈0.001）.One or two weeks after surgery,the basilar artery diameter was expanded （0.60 mm vs 0.82 mm; 0.73 mm vs 1.03 mm,P 〈0.001）,and the artery was curved.The internal elastic layer of artery was intact with smooth muscle cells proliferation in response to high flow and shear stress.The basilar artery was bent to the left side in 57.1% of all rabbits and there was significant difference compaared with that of preoperafion.Condusions The hemedynamic increasing of the basilar artery after bilateral common carotid artery ligation of New Zealand white rabbits resulted in expansion and tortuosity of the basilar artery.