【摘要】 目的研究牵张力介导的力生长因子高表达对临床支架再狭窄的作用,并探讨其相关机制,为临床解决支架再狭窄提供理论依据。方法随机将雄性Beagle犬分成两组,每组7只:支架植入组在前降支近中段植入3 mm×16 mm支架对支架植入组动物冠脉内支架植入情况进行评估。1个月后对再狭窄的冠状动脉行病理切片染色检测;电镜观测;原位杂交技术评估血管平滑肌细胞的力生长因子mRNA表达,Western blot检测靶血管的血管平滑肌细胞力生长因子蛋白表达水平,检测血清力生长因子水平。采用SPSS 17.0统计学软件进行统计学分析。结果两组实验动物在术后均未见血管狭窄;支架植入后1个月冠状动脉病理学分析提示支架植入组可见内膜增厚、冠脉平滑肌细胞增殖、迁移、炎症细胞明显浸润及血栓形成,导致管腔狭窄,经皮球囊冠状动脉成形术组未见明显改变;电镜观察发现平滑肌细胞细胞器数量增多及体积增大;原位杂交法及Western blot结果提示支架植入1个月后靶血管的平滑肌细胞高表达力生长因子,且与经皮球囊冠状动脉成形术组相比(P<0.01),差异有统计学意义;而术前及术后两组力生长因子血清学水平则无明显差异。结论力生长因子是力敏感性的因子,支架扩张造成血管壁牵张力增加,促进炎症反应,促进支架再狭窄的发生。更多还原

【Abstract】 Objective To study the effect of high expression of force growth factor( FGF) mediated by traction on clinical stent restenosis and to explore its mechanism,so as to provide theoretical basis for clinically treating stent restenosis.Methods Male beagle dogs were randomly divided into 2 groups,7 dogs in each group.In the stent implantation group,3.0 * 16 mm stent was implanted in the proximal middle segment of anterior descending artery and the implantation effect was evaluated.One month later,the restenosis of coronary artery was examined by pathological section staining,electron microscope observation,in situ hybridization was used to assess force growth factor expression in vascular smooth muscle cells; and Western blot was used to test the expression level of VEGF protein in the target vessel and serum levels of force growth factor.SPSS 17.0 software was used for statistical analysis.Results No stenosis was found in both groups after surgery.The pathological analysis of coronary artery showed intimal thickening,proliferation and migration of smooth muscle cells occurred in the stent implantation group,and moreover,infiltration of inflammatory cells and formation of thrombosis were observed,resulting in lumen stenosis,with no significant change found in the percutaneous balloon coronary angioplasty group; According to electron microscopy observation,there was increase in number and volume of smooth muscle cell organelles; the results of in situ hybridization and Western blot showed that the expression of FGF was higher in the smooth muscle cells of the target vessel one month after the stent implantation,and the difference was statistically significant compared with that of the percutaneous balloon angioplasty group( P< 0.01),but there was no significant difference in the serum level of FGF between the two groups before and after the stent implantation.Conclusion Force growth factor is a force sensitive factor,and therefore,stent dilation can increase the tension of vascular wall,cause the inflammatory response and the occurrence of stent restenosis.更多还原