摘要
观察血管成形术后血管壁各部分变化在再狭窄发生中的作用。利用家兔骼动脉粥样硬化模型行球囊扩张术，用组织形态测量的方法研究术后即刻（急性组，n=20）及术后4周再狭窄发生时（慢性组，n=23）血管内膜面积、中膜面积、腔面积、内弹力板围绕面积、外弹力极围绕面积的变化。以血管直径减少扩张即刻管径的30％为再狭窄的标准，将慢性组进一步分为非再狭窄亚组（NRS，n=9）与再狭窄亚组（RS，n=14），对此二亚组血管形态测量结果进行进一步研究。慢性组腔面积较急性组腔面积显著减小0．48mm（0．38±0．20vs0．86±0．23，P＜0．001），内膜增生仅0．12mm（0．40±0．26vs0．28±0．09，PM0．05），而内弹力板围绕面积则减少0．36mm（1．14±0．27vs0．78±0．31，P＜0．001）。内膜增生仅可解释25％后期管腔面积损失。对慢性组进一步分组研究发现，两亚组内膜增生面积无差别（0．41±0．310．39±0．16VS，P=NS），而再狭窄亚组内弹力板围绕面积却显著减小（0．6±0．350．94±0．14vs，P＜0．05）。再狭窄亚组内弹力板的明显回缩是导致两亚组之间管腔面积（0．27±0．10vs0．55±0．10，PM0．001）显著不同的主要原因。内膜增生与血管收缩（重塑）共同促进血管成形术后管腔面积减小，但血管收缩（重塑?
To evaluate the relative contribution of every part of vascular to later lumen area loss after angioplasty.Angioplasty were performed on rabbits iliac atherosclerosis mode.Histomorphometric results of histological cross-sectional areas from target vascular of animals killed immediately after angioplasty (acute group n=20) were compared with that of the same area from animals killed 4 weeks after the procedure (chronic group n= 23),when restenosis occurs in this model.If taken 30% diameter decrease as restenosis criteria,the chronic group was further divided into two subgroups (nonrestenosis subgroup NRS n=9 and restenosis subgroup RS n=14) and their histomorphometric results were also compared. The lumen area decreased by 0. 48 mm2 from acute group to chronic group (acute group 0. 86± 0. 23 vs chronic group 0. 38 ± 0. 20,P<0. 001). Over the same period intimal area increased by 0. 12 mm2 and the area circumscribed by inner elastic lamina (IEL area) decreased by 0. 36 mm2. Intimal hyperplasia could contribute to only 25 % of the late lumen loss. We further found a significant IEL area decrease in RS subgroup (0. 68± 0. 35 vs 0. 94± 0. 14,P<0. 05),despite the same intimal area (0. 41 ± 0. 31 vs 0. 391 0. 16,P=NS). The different lumen area between RS subgroup and NRS subgroup (0. 27 ± 0. 10 vs 0. 55 ± 0. 10, P<0. 001 ) were predominantly due to the larger IEL shrinking in RS subgroup. Our data indicated that lumen area later loss after angioplasty was resulted from both intimal hyperplasia and arterial shrinking (remodeling),but the latter played a much greater role.
出处
《中国介入心脏病学杂志》
1998年第1期35-37,共3页
Chinese Journal of Interventional Cardiology
关键词
血管成形术
再狭窄
冠状动脉
重构
Restenosis angioplasty Coronary Artery Remodeling
