【摘要】 目的:建立大鼠颈动脉再狭窄模型,原位灌注固定取材。评价PTA后血管重塑(VR)的动态变化规律,定量分析血管重塑在血管再狭窄过程中的变化及作用。方法:制作70只SD雄性大鼠颈总动脉再狭窄模型,分原位灌注实验组、对照组,于术后1h、3、7、14、28和42天原位灌注固定取材,行HE染色、Masson染色,观察标本血管狭窄情况。结果:①血管重塑指数(VRI)在PTA后即刻最大,3天组明显降低,7天组稍有增大,其后不断减小,剩余血管腔面积百分比同VRI的变化曲线基本一致。②PTA后,血管腔面积总体呈逐渐缩小趋势,内弹力板围绕面积(IELA)1h组较对照组明显增大,3天组较1h组明显缩小,14、28、42天组较对照组明显缩小。外弹力板围绕面积(EELA)逐渐缩小。EELAI、ELA的变化与血管腔面积变化呈正相关。③VRI与血管腔面积的变化呈正相关,新生内膜面积与剩余狭窄率、血管腔面积无直线相关。结论:再狭窄过程中存在扩张性重塑和收缩性重塑现象,管腔的狭窄与否取决于血管重塑指数的变化,而不是新生内膜的变化,新生内膜的形成是血管重塑过程中的一部分。IELA和EELA可作为判断管腔狭窄及评价血管重塑的指标。更多还原

【Abstract】 Objective:To create the rat common carotid artery injury model,draw the materials from arteries after in situ perfusion and fixation.To evaluate the dynamic changes of vascular remodeling(VR) after percutaneous transluminal angioplasty(PTA),quantitative analysis changes and effects of VR during vascular restenosis.Methods:70 male Sprague-Dawley rats were divided into 2 groups,in situ perfusion group,control group.Common carotid artery(CCA) injury model were created in one side,the contralateral side acts as control. Specimens on both sides were harvested at six time points that was 1hour,3rd,7th,14th,28th and 42nd days.According to the HE,Masson staining slices,vascular restenosis specimens were oberserved.Results: ① VRI reached maximum shortly after PTA,decreased distinct in 3th days groups,slight increased in 7th days groups,then gradually decreased,the percentage of residual luminal areas changed consistently with VRI;② After PTA,LA(luminal area)gradually decreased,1h group increased distinctly,3th days group reduced distinctly compared with 1h group,no difference between 3th days group and 7th days group,compared with 7th days group,14th,28th and 42nd days group reduced distinctly compared with control group,IELA of 1h group increased distinctly,3th days group reduced distinctly compared with control group and 7th days group,14th,28th and 42nd days group reduced distinctly.EELA gradually decreased;③ There were positive correlation between VRI and LA change.There were no correlation among neointima and residual restenosis and LA.Conclusion:There were expand remodeling and contractive remodeling during restenosis,the change of LA rest on variety of VRI rather than neointima,the form of neointima was course of VR.IELA and EELA are important parameter to evaluate change of LA and VR.更多还原