经外膜缓释雷公藤内酯醇抑制自体移植静脉内膜增生
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Adventitia applied slow-releasing triptolide inhibits intima hyperplasia in vein graft
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    摘要:

    目的:探讨经外膜缓释雷公藤内酯醇(triptolide)对自体移植静脉内膜增生的抑制作用。
    方法:健康雄性新西兰大白兔24只,建立颈外静脉-颈总动脉移植模型。随机将动物等分为3组。空白组移植血管不给任何处理, F-127多聚凝胶对照组在移植血管外膜喷洒20 %F-127多聚凝胶0.5 mL,实验组在移植血管外膜喷洒携带雷公藤内酯醇300μg的F-127多聚凝胶0.5 mL。术后2周取标本。用组织形态学方法检测血管内膜增生程度,免疫组化检测标本中bcl-2和Fas的表达,TUNEL法检测标本中血管平滑肌细胞(VSMC)凋亡的水平。
    结果:静脉移植2周后,与空白组和F-127对照组比较,实验组血管内膜增生明显受抑制(P<0.05),bcl-2的表达[(18.2±8.4) %]显著减少,而Fas的表达[(21.4±8.9) %]显著增加,凋亡细胞[(28.4±7.6) %]也显著增加(P<0.05)。
    结论:经外膜缓释雷公藤内酯醇可有效抑制移植静脉内膜增生,这一作用可能系通过促进VSMC凋亡而实现的。

    Abstract:

    Abstract:Objective:To investigate the inhibitory effect of appling slow-releasing triptolide on adventitia on the intima hyperplasia of autologous vein graft.
    Methods :In 24 male New Zealand rabbits, external jugular vein to common carotid artery models were established, and then were divided into 3 equal groups at random: blank-control group, receiving no management on adventitia of the vein graft; F-127 control group, receiving local application of 0.5 mL of 20 % F-127 on adventitia of the vein graft; experiment group, receiving local application of 0.5 mL of 20 % F-127 containing triptolide 300μg. Vein graft specimens were harvested at 2 weeks after the operation. Histomorphologic methods were used to detect the degree of intima hyperplasia of the specimens. The expression of bcl-2 and Fas of the specimens was detected by immunohistochemistry. The apoptosis vascular smooth muscle cells (VSMC) were detected by TUNEL.
    Results:Two weeks after vein grafting, compared to blank-control group and F-127 control group, intima hyperplasia of experiment group [intima thickness (29.9±7.6)μm, I/M 0.56±0.08] was markedly inhibited (P<0.05). Expression of bcl-2[(18.2±8.4)%] was reduced significantly, however, expression of Fas(21.4±8.9)% increased markedly, and the apoptotic cells [(28.4±7.6)%] also increased markedly (P<0.05).
    Conclusions:Applied slow-releasing triptolide by F-127 pluronic on the vein graft adventitia can effectively inhibit intima hyperplasia of vein graft by a mechanism of enhancement of VSMC apoptosis.

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武国, 时德.经外膜缓释雷公藤内酯醇抑制自体移植静脉内膜增生[J].中国普通外科杂志,2007,16(12):7-115.
DOI:10.7659/j. issn.1005-6947.2007.12.007

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  • 在线发布日期: 2007-12-25