地塞米松预防兔移植静脉再狭窄的实验研究

Experimental study of dexamethasone on prevention of restenosis in rabbit vein grafts

目的:观察局部应用地塞米松对新西兰兔自体移植静脉再狭窄的影响,并探讨其可能的作用机制。方法:新西兰兔30只,建立兔自体颈外静脉-颈总动脉移植模型,随机分3组:空白对照组、生物蛋白胶组和地塞米松组。各组动物分别于术后3周测量内膜、中膜厚度及管壁炎性细胞数、周期蛋白(PCNA)阳性细胞率和凋亡细胞阳性率。结果:术后3周,地塞米松组较生物蛋白胶组、空白对照组均明显降低内膜、中膜增生厚度,炎性细胞数减少;生物蛋白胶组较空白对照组也可抑制内膜、中膜厚度增生,3组数据PCNA阳性细胞率、凋亡细胞阳性率差异有统计学意义(P<0.05)。结论:地塞米松在新西兰兔自体静脉移植中能通过抑制局部炎性反应,抑制平滑肌细胞增殖、促使血管平滑肌细胞凋亡,从而防止移植静脉再狭窄。

Objective:To observe the effect of dexamethasone on the restenosis of autologous vein graft in New Zealand rabbits,and to explore its possible mechanism.Methods:30New Zealand rabbits were selected.A rabbit model of autogenous external jugular vein graft was established.They were randomly divided into the3groups:the blank control group,the fibrin glue group,and the dexamethasone group.The intima media thickness,the number of inflammatory cells,the number of circulating cells(PCNA)and the positive rate of apoptotic cells were measured at3weeks postoperatively of all animals.Results:At3weeks after operation,the thickness of intima and media was significantly lower in the dexamethasone group than that in the fibrin glue group and the control group,and the number of inflammatory cells decreased.Compared with the blank control group,the fibrin glue group inhibited the proliferation of intima and media thickness,and the positive rate of PCNA positive cells and apoptotic cells were significantly different among the3groups,with statistically significant(P<0.05).Conclusion:Dexamethasone can inhibit local inflammatory response and the proliferation of vascular smooth muscle cells and promote the apoptosis of vascular smooth muscle cells,which can prevent the restenosis of vein grafts.