【摘要】 目的　研究10 3 Pd支架预防血管成形术后再狭窄的作用机理。方法　将雄性新西兰大白兔 50只随机分为普通支架组及10 3 Pd支架组 ,各组再分 5个亚组 ,设正常对照。分别于术后第 3、7、14、2 8、56天取材 ,进行病理形态学、细胞凋亡定量研究 ,用原位杂交法测定凋亡相关基因bcl 2mRNA及baxmRNA的表达。结果　光镜下发现 ,10 3Pd支架组管腔狭窄程度明显低于普通支架组 ,术后第 56天最显著 (P <0 0 1)。末端脱氧核糖核酸转移酶介导的脱氧尿苷三磷酸缺口末端标记 (TUNEL)法检测发现术后 3～ 2 8d ,10 3 Pd支架组的平滑肌细胞凋亡较普通支架组明显 ,术后第 7天达峰值 (P <0 0 1)。原位杂交显示术后 3～ 2 8d 10 3Pd支架组bcl 2mRNA的表达较普通支架组降低 ,术后第 2 8天达峰值 (P <0 0 1)。而baxmRNA的表达 ,术后 3～ 2 8d10 3 Pd支架组较普通支架组显著增加 ,术后第 7天达峰值 (P <0 0 1)。术后 3～ 2 8d ,10 3 Pd支架组的bcl 2mRNA与baxmRNA比值均小于普通支架组(P <0 0 5)。直线相关分析示 ,bcl 2mRNA与TUNEL法测定的凋亡阳性率呈明显负相关 ,而baxmRNA与之呈明显正相关 (P <0 0 1)。结论　10 3 Pd支架通过诱导凋亡相关基因的表达 ,导致明显的中膜平滑肌细胞凋亡 ,使凋亡细胞比例增加 ,血管再狭窄程度更多还原

【Abstract】 Objective To evaluate the influence of 103 Pd radioactive stent on apoptosis and its relative genes bcl-2 and bax in injured vascular media smooth muscle ce lls of rabbit abdominal arteries and to investigate the mechanism of 103 Pd radioactive stent for preventing restenosis after angioplasty. Methods Fifty male New Zealand rabbits were randomized into stent group and 103 Pd stent group. Each group was subdivided into 5 sub-grou ps. Control group was set up. The study arteries were harvested at 3, 7, 14, 28 and 56 d after stenting and the pathomorphology, apoptosis analysis and in s itu hybridization were performed to evaluate the expression of bcl-2 and bax m RNA. Results The severity of the restenosis in 103 Pd stent group was less than that of stent group. It was most obvious at the 56th day ( P <0.01). Using terminal deoxynucleotidyl transferase-mediated dUTP nic k end labeling (TUNEL) method it was found that the 103 Pd stent g roup had much more apoptosis of vascular smooth muscle cells than stent group di d and reached the peak at the 7th day, (14.72±0.53)% vs (12.42±1.13)% ( P <0.01). In situ hybridization analysis showed that the expression of bcl-2 mRNA of 103 Pd stent group was much lower than that of stent group at 3 to 28 d. The difference was most obvious at the 28th day after stenting, (18.43±0.67)% v s (21.55±0.93)% ( P <0.01). The expression of bax mRNA of 103 Pd stent group was higher than that of stent group, the peak was at the 7th day, (11.17±0.94)% vs (9.30±1.01)%. The ratio of bcl-2/bax in 103 Pd stent group was much lower than that of stent group at 3 to 28 d. Linear corre lation analysis showed that there was significant negative correlation between bcl-2 mRNA and apoptosis. Between bax mRNA and apoptosis, the positive correlat ion was found ( P <0.01). Conclusion 103 Pd radioactive sten t induced more significant apoptosis in vascular media smooth muscle cells by pr omoting the expression of apoptosis related genes and relieved the expanding of resteno sis.更多还原