目的通過血管內放射防治頸動脈內膜剝脫術(CEA)后再狹窄，動態觀察其對中膜平滑肌細胞(SMC)凋亡和增殖的影響，并初步探討其防治再狹窄的可能機理。方法40只兔行CEA后，隨機分為4組，分別給予0 Gy、10 Gy、20 Gy及40 Gy放射劑量的32P，于術后3 d、7 d、14 d、28 d及56 d分別處死動物，取出血管標本進行病理組織學分析。結果術后除3 d及7 d外，對照組發生明顯內、中膜增生及管腔狹窄，而內放射組可見內、中膜增生明顯受抑制，管腔面積縮小顯著減輕(P＜0.05)。SMC凋亡率和細胞增殖核抗原(PCNA)陽性細胞均于術后3 d增加，7 d時達高峰，治療組與對照組比較差異有顯著性意義(P＜0.01)； 20 Gy和40 Gy的作用明顯強于10 Gy組(P＜0.01)。結論內放射治療可能是通過抑制SMC增殖、遷移，誘導SMC凋亡，防治再狹窄，并且隨劑量呈遞增效應； 球囊損傷后早期以細胞增生和凋亡為主要表現，晚期表現為內、中膜面積的增加。
引用本文：
盧輝俊陳國玉. 內放射對兔頸動脈術后中膜平滑肌細胞增殖與凋亡的影響. 中國普外基礎與臨床雜志, 2004, 11(4): 300-304. doi:
復制
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- 1. Waksman R, Rodriguez JC, Robinson KA, et al. Effect of intravascular irradiation on cell proliferation, apoptosis, and vascular remodeling after balloon overstretch injury of porcine coronary arteries [Ｊ]. Circulation, 1997; 96(6)∶ 1944.
- 2. Clowes AW, Clowes MM, Fingerle J, et al. Kinetics of cellular proliferation after arterial injury. V. Role of acute distension in the induction of smooth muscle proliferation [Ｊ]. Lab Invest, 1989; 60(3)∶360.
- 3. Kim HS, Kollum M, Chan RC, et al. A novel 32P deployable balloon system inhibits formation of neointima in porcine coronary arteries after balloonoverstretching injury [Ｊ]. Coron Artery Dis, 2001; 12(4)∶317.
- 4. Carter AJ, Laird JR, Farb A, et al. Morphologic characteristics of lesion formation and time course of smooth muscle cell proliferation in a porcine proliferative restenosis model [Ｊ]. J Am Coll Cardiol, 1994; 24(5)∶1398.
- 5. Crowley ST, Ray CJ, Nawaz D, et al. Multiple growth factors are released from mechanically injured vascular smooth muscle cells [Ｊ]. Am J Physiol, 1995; 269(5 Pt 2)∶H1641.
- 6. 廖明芳， 景在平. 一氧化氮供體及一氧化氮合酶抑制劑與動脈疾病 [Ｊ]. 中國現代普通外科進展， 2002； 5（2）∶74.
- 7. Fischell TA, Kharma BK, Fischell DR, et al. Lowdose, betaparticle emission from ‘stent’ wire results in complete, localized inhibition of smooth muscle cell proliferation [Ｊ]. Circulation， 1994; 90(6)∶2956.
- 8. Verin V, Popowski Y, BochatonPiallat ML, et al. Intraarterial beta irradiation induces smooth muscle cell apoptosis and reduces medial cellularity in a hypercholesterolemic rabbit restenosis model [Ｊ]. Int J Radiat Oncol Biol Phys， 2000; 46(3)∶661.
- 9. Waksman R, Robinson KA, Crocker IR, et al. Intracoronary lowdose betairradiation inhibits neointima formation after coronary artery balloon injury in the swine restenosis model [Ｊ]. Circulation， 1995; 92(10)∶3025.
