【摘要】 目的　探讨血管内皮生长因子 (vascularendothelialgrowthfactor,VEGF)局部转染预防血管内支架再狭窄的作用。方法　家犬 2 4只 ,按随机数字表法分为实验组与对照组各 12只 ,每组再分为 2个亚组各 6只 ,分别用于支架置入术后第 1周和第 8周取材检测各项指标。实验组置入VEGF涂布支架 ,对照组直接置入支架。术后第 1周处死的动物取部分支架内组织及动物心、肝、肺、肾、眼组织用于检测VEGF的表达 ,同时一部分支架组织还用于扫描电子显微镜观察。术后第 8周的动物处死前先行肝静脉造影复查 ,了解支架开放情况 ;然后取邻近支架肝静脉血管组织及心、肝、肺、肾、眼组织用于光学显微镜观察。结果　两组动物支架置入前肝静脉平均内径统计学上差异无显著性意义(t=1 16,P >0 0 5 )。术后第 1周通过逆转录聚合酶链反应 (reversetranscription polymerasechainreaction ,RT PCR)法检测到实验组支架局部血管组织内VEGF表达 ,同时扫描电子显微镜观察支架腔面内皮化程度实验组明显优于对照组。术后第 8周肝静脉造影复查 ,实验组支架开放情况明显优于对照组 (t=2 1,P <0 0 1) ;光学显微镜观察实验组平均新生内膜厚度、平均新生内膜面积、平均百分狭窄面积均显著优于对照组 (t值分别为 6 0 1、4 5 5和 5 67,P <0 0更多还原

【Abstract】 Objective To investigate the effect in preventing restenosis of hepatic venous stents by local transfer of vascular endothelial growth factor (VEGF) in dogs. Methods Twenty-four dogs were divided into test group and control group randomly (12 dogs in each group). Each group was divided into 2 subgroup (6 dogs in each subgroup) in order to collect samples at different times. VEGF-coated metallic stents were placed into hepatic veins in test group and bare metallic stents were placed in control group. Vascular tissues covering stents and organs (heart, liver, lung, kidney, and eyes) were used to detect the expression of VEGF at first week after stent placement. Parts of the intra-stent vascular tissues were also studied by means of scanning electron microscopy. The dogs that were followed up for 8 weeks underwent hepatic venography before they were killed to assess the patent extent of stents. The vascular tissues near the stents and organs (heart, liver, lung, kidney, and eyes) were used for observation under the optical microscope. Results Preoperative venography showed that there were no significant differences in the mean diameter of hepatic veins between the two groups. At the first week after stent placement, the expression of VEGF in vascular tissues covered by stents was detected by RT-PCR technique in test group, and it was proved that test group was superior to control group clearly in the endotheliosis by scanning electron microscopy. At the postoperative eighth week, hepatic venography showed that the patency of stents in test group was also superior to that in control group (t=21,P<0.01), and light microscope demonstrated that mean neiontime?(neointima) thickness, mean neiontime?(neointima) area, and mean percentage area of narrowing in test group was significantly less than that in control group, respectively (t=6.01, 4.55, 5.67 respectively, P<0.01). Conclusion The local transfer of VEGF can accelerate the endothelization covered stents in hepatic vein and prevent the formation of restenosis.更多还原