生长激素对人工血管内皮化的影响

The effects of growth hormone on artifical vessel endothelialization

目的观察重组人生长激素对人工血管内皮化的影响。方法对28条北京地区杂种犬进行腹主动脉人工血管移植，术后随机分为实验组（E组，17,=14）和对照组（C组，n=14），E组自术后当天起重组人生长激素（rhGH）0．1IU／（kg·d），连续两周定时皮下注射，C组术后不予注射rhGH，余处理相同。分别于术后第1、2、3个月获取标本，术后1个月E组和C组各取2条杂交犬（分别为E1m组／Z=2，Clm组n=2），术后2、3个月各取6只杂交犬（分别为E2m组n=6，E3m组n=6和C2m组n=6，C3m组n=6），取移植物通过苏木素一伊红（HE）染色、光镜、透射电镜、扫描电镜等方法观察超微结构变化，测定并比较两组内皮细胞数目和内膜厚度。结果（1）术后1个月：电镜下两组材料内表面有纤维膜覆盖，均可见少量散在梭形细胞，但E1m组内皮细胞超微结构发育较对照组完善。（2）术后2个月：E2m组梭形细胞完全覆盖材料内表面，排列紧密，细胞结构发育成熟，细胞间连接紧密；而C2m组梭形细胞散在分布，连接不紧密，内皮细胞足突少，胞质水肿，核质疏散，材料内表面大量纤维组织增生。（3）术后3个月：E3m组内皮下可见少量的纤维细胞和平滑肌细胞增生，C3m组内膜明显增厚，材料表面血栓细胞和纤维细胞呈“烂棉絮”样覆盖。（4）计算机图像分析结果：E2m和E3m内膜厚度均显著小于对照组（P〈0．01）。内皮细胞计数E2m组内明显多于C2m组（P〈0．01）；E3m和C3m差异无统计学意义（P〉0．05）。结论rhGH对内皮细胞增殖、减轻内膜增生、促内皮细胞成熟有一定作用。

Objective To explore the effects of recombinant human growth hormone （rhGH） on endothelialization of vascular prosthesis. Methods 28 mongrel dogs in Beijing area were divided randomly into the experiment＇ s group （ group E, n = 14） and the contrast＇ s group （ group C, n = 14）. All animal＇ s abdominal aorta were replaced with the expanded polytetra - fluoroethylene （ e - PTFE）. Since the day while the operation ended, the dogs in group E were the same as those in group E. The dogs were executed 1 month, 2 months, and 3 months after operation respectively （group Elm n =2, group E2m n =6, group E3 m n = 6, group Clm n = 2, group C2m n = 6, group C3 m n = 6）. Then we observed the change of endo- membrane uhramicrostructure of grafts and determined the thickness of artificial vascular endomembrane and accounted endothelial cells by means of HE staining, light microscope, transmission electron micro- scope and scanning electron microscope. Results （ 1 ） Fibrous membrane covers on internal surface of grafts in group Elm and Clm, where we can find small amounts of spindle cells. But the ultramicrostruc- ture formation of endomembrane in group Elm is more consummate than that in group Clm. （2） There is a completed endothelial layer covered the entire internal surface of grafts in group E2m. The endothelial cells are matured and conjunct tightly. But the endothelial cells in group C2m are distributed irregulatedly and conjunct untightly. Few foot processes of endothelial cells can be observed, periplast is dropsy, caryo- plasm is scattered. There is a lot of fibroplasia on internal surface of grafts in group C2m. （3） There are a litter fibrocytes and smooth muscle cells under endothelium in group E3m. Endomembrane of grafts in group C3m are obviously thickening, thrombocytes and fibrocytes cover the internal surface of grafts like fluffed cotton. （4） Computer image analysis results： the thickness of Endomembrane in group E2m and E3m are obviously thinner than those in group C2m and C3m respectively （P 〈 0. 01 ）. The number of en- dothelial ceils in group E2m is more than that in group C2m （P 〈 0. 01 ）. There is no significant difference between group E3m and C3m on endothelial cell counting. Conclusion Administration of rhGH may im- prove endothelial cell multiplication and maturity, and relieve accrementition of endomembrane.