【摘要】 为研究Cilostazol对犬股动脉人工血管移植吻合处内膜增生的作用,用直径3 mm、长2 cm的Gore-TexR重建犬股动脉.实验分Cilostazol组和对照组,每组10只犬,Cilostazol组从术前1天开始口服Cilostazol,50 mg/(kg.d),直到取材;术后2,6,12,20,24周取材,每组各时相点2只(4条血管),观察移植物通畅率,进行常规组织学检查,测量吻合处内膜厚度,电镜观察吻合处超微结构改变.结果发现:①Cilostazol组于术后6,12,20周各有1条血管闭塞,24周有2条血管闭塞,对照组术后2,6,12周各有2条血管闭塞,20,24周各有3条血管闭塞;Cilostazol组通畅率为75%,对照组为40%,两组有显著性差异(p<0.05).②术后2周时吻合处内膜无明显增厚,材料面开始有内皮细胞覆盖,术后6周材料面被内皮完全覆盖,吻合处内膜增厚,引起管腔狭窄,随时间的延长,内膜逐渐增厚;Cilostazol组内膜增生较对照组轻,对照组术后6,12,20,24周邻接动脉内膜厚度分别是Cilostazol组的1.4,1.6,2.0,1.6倍,材料面新内膜厚度两组比较无明显差异.认为Cilostazol可以抑制人工血管犬股动脉重建后吻合处内膜的增生,从而防止再狭窄,提高通畅率.更多还原

【Abstract】 Objective: To study the effects and mechanisms of cilostazol on intimal hyperplasia at the anastomotic site on synthetic graft implantation model.Methods: A canine femoral artery interposition model was fabricated with 3 mm graft of PTFE tube,2 cm in length with a wall thickness of 0.5 mm.Twenty dogs were divided into two groups(10 in each): the cilostazol group and the control group.The dogs in the cilostazol group were fed cilostazol(pletaal,50 mg/(kg·day)),started 1 day before operation and continued until harvest.Specimens(grafts and 1 cm adjacent recipient arteries) were taken 2,6,12,20,24 weeks after the implantation to examine the patency,histomorphological changes,thickness of the intima and the ultrastructural changes by electron microscopy.Results: ① Grafts had a patency of 40% in the control group with 2 occluded in the 2nd,6th and 12th weeks,and 3 occluded in the 20th and 24th weeks,and a patency rate of 75% in the cilostazol group,with one occluded in the 6th,12th and 20th weeks,and 2 occuled in the 24th week,the difference being statistically significant between the two groups(p<0.05).② Intima thickness increased gradually as time went by.In the control group,the intima thickness of the adjacent arteries were 1.4,1.6,2,1.6-fold thick of the cilostazol group at age 6,12,20,24 weeks,respectively(p<0.05),but no significant difference existed between the neointima thickness on the grafts of the two groups.Conclusion: In the Gore-TexR-reconstructed canine femoral model,cilostazol inhibited the intimal hyperplasia at the anastomotic site,reduced the restnosis and improved the patency rate.更多还原