颈椎旋转手法对兔颈动脉重度粥样硬化斑块稳定性的影响

Effects of cervical rotatory manipulation on the stability of rabbit with severe carotid atherosclerotic plaque

目的:探讨颈椎旋转手法对兔颈动脉重度粥样硬化(CAS)斑块稳定性的影响。方法:40只新西兰兔随机分为颈椎旋转组(15只)、CAS组(15只)、对照组(10只),颈椎旋转组和CAS组兔行左侧颈总动脉CAS造模;造模成功后,颈椎旋转组予颈椎旋转手法治疗2周,CAS组和对照组不干预。每组于造模后、手法干预后分别取血浆检测hs-CRP的浓度;手法干预后处死所有兔,取左侧颈动脉行HE、Masson三色和CD68免疫组化染色,半定量分析斑块中脂质、胶原纤维、巨噬细胞的含量。结果:(1)与对照组比较,颈椎旋转组和CAS组兔造模后的血清hs-CRP水平显著性升高(P<0.05);(2)与手法干预前比较,干预后颈椎旋转组兔的血清hs-CRP水平升高(P<0.05);(3)与CAS组和对照组比较,手法干预后颈椎旋转组兔的血清hs-CRP水平升高(P<0.05);(4)与CAS组比较,颈椎旋转组的胶原纤维在斑块处明显减少、CD68阳性表达水平显著下降(P<0.05)。结论:颈椎旋转手法可致兔颈动脉重度粥样硬化斑块稳定性下降,增加斑块脱落的风险。

Objective： To investigate the effects of cervical rotatory manipulation（CRM） on the stability of rabbit with severe carotid atherosclerotic（CAS） plaques. Methods： A total of 40 New Zealand rabbits were randomly divided into 3 groups： CRM group（n=15）, CAS group（n=15） and blank-control group（n=10）. Left CAS plaques model was established in the CRM group and CAS group. Then, the CRM group was treated with CRM lasting for 2 weeks, meanwhile no intervention was used on the CAS group and blank-control group. All the groups were taken the plasma to detect the hs-CPR concentration after modeling or treatment. After manipulation, the left carotid was used for the HE staining, Masson tricolor and CD68 immunohistochemistry, and the contents of lipids, collagen fibers and macrophages in the plaques were quantitatively analyzed. Results：（1）The serum level of hs-CRP in the CRM group and CAS group was higher than blank-control group（P〈0.05）.（2）The serum level of hs-CRP in CRM group increased after manipulation（P〈0.05）.（3）The serum level of hs-CRP after manipulation in CRM group was higher than the CAS group and blank-control group（P〈0.05）.（4）Compared with the CAS group, the collagen fibrils in plaques and the expression level of CD68 in CRM group were significantly decreased（P〈0.05）. Conclusion： CRM may decrease the stability of rabbit＇s carotid atherosclerotic plaques and increase the risks of plaque rupture.