脐带血干细胞移植对兔糖尿病后肢血管病变介入术后支架内再狭窄的影响

The effect of umbilical cord blood stem cell transplantation on the in-stent restenosis after intervention therapy for diabetic vascular diseases in experimental rabbits

目的观察脐带血干细胞移植对糖尿病实验兔后肢血管病变血管内介入术后支架内再狭窄的影响。方法制备糖尿病后肢血管病变兔模型22只,随机分成A组(n=8,介入术联合脐带血干细胞移植)、B组(n=8,单纯介入术)、C组(n=6,未治疗干预)、D组(n=6,未制模,为正常对照)。采用酶联免疫吸附试验分别测定血清血管内皮钙黏蛋白(VE-cadherin)和血浆脂蛋白相关磷脂酶A2(LpPLA2)水平,苏木精-伊红染色测定新生内膜面积及内膜面积与中膜面积比值。结果治疗后A组VEcadherin和Lp-PLA2水平明显低于B、C组(P均<0.01),与D组比较差异无统计学意义(P>0.05)。A组兔股动脉有轻度内膜中断和增生,弹力膜轻度断裂;A组内膜面积、内膜面积与中膜面积比值均显著小于B、C组(P均<0.05),与D组比较差异无统计学意义(P>0.05)。结论脐带血干细胞移植可有效保护血管内介入术后血管内皮损伤,预防术后支架内再狭窄。

Objective To observe the effect of umbilical cord blood stem cell transplantation on the in- stent restenosis （ISR） after intervention therapy for diabetic vascular diseases in experimental rabbits. Methods A total of 22 rabbit models with diabetic hind limb vascular diseases were prepared. The rabbits were randomly divided into group A （ n = 8, receiving umbilical cord blood stem cell transplantation together with interventiona] therapy）, group B （n= 8, receiving interventional therapy only） , group C （n = 6, receiving no intervention） and group D （n = 6, not being prepared, used as normal control group）. Using enzyme linked immunosorbent assay, the levels of vascular endothelial cadherin （VE-cadherin） and lipoprotein-associated phospholipase A2 （Lp-PLA2） were separately measured; HE staining was used to determine the newly-grown intimal area as well as the ratio of membrane area to medium area. Results After treatment, the levels of VE-cadherin and Lp- PLA2 in group A were significantly lower than those in group B and group C （both P〈0.01）, while no statistically significant differences in the levels of VE-cadherin and Lp-PLA2 existed between group A and group D （P〉0.05）. In the rabbits of group A, mild intimal disruption and proliferation, and slight fracture of elastic membrane of the femoral artery could be observed ; both the newly-grown intimal area and the ratio of membrane area to medium area of group A were significantly smaller than those of group B and group C （both P〈0.05）, although the difference between group A and group D was not statistically significant （P〉0.05）. Conclusion Umbilical cord blood stem cell transplantation can effectively protect vascular endothelium from injuries caused by endovascular intervention procedure and prevent the occurrence of postoperative ISR.