目的通過(guò)血管內(nèi)放射防治頸動(dòng)脈內(nèi)膜剝脫術(shù)(CEA)后再狹窄，動(dòng)態(tài)觀察其對(duì)中膜平滑肌細(xì)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(jī)理。方法40只兔行CEA后，隨機(jī)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(shù)后3 d、7 d、14 d、28 d及56 d分別處死動(dòng)物，取出血管標(biāo)本進(jìn)行病理組織學(xué)分析。結(jié)果術(shù)后除3 d及7 d外，對(duì)照組發(fā)生明顯內(nèi)、中膜增生及管腔狹窄，而內(nèi)放射組可見(jiàn)內(nèi)、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(xì)胞增殖核抗原(PCNA)陽(yáng)性細(xì)胞均于術(shù)后3 d增加，7 d時(shí)達(dá)高峰，治療組與對(duì)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(qiáng)于10 Gy組(P＜0.01)。結(jié)論內(nèi)放射治療可能是通過(guò)抑制SMC增殖、遷移，誘導(dǎo)SMC凋亡，防治再狹窄，并且隨劑量呈遞增效應(yīng)； 球囊損傷后早期以細(xì)胞增生和凋亡為主要表現(xiàn)，晚期表現(xiàn)為內(nèi)、中膜面積的增加。
引用本文： 盧輝俊陳國(guó)玉. 內(nèi)放射對(duì)兔頸動(dòng)脈術(shù)后中膜平滑肌細(xì)胞增殖與凋亡的影響. 中國(guó)普外基礎(chǔ)與臨床雜志, 2004, 11(4): 300-304. doi: 復(fù)制
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- 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(dòng)脈疾病 [Ｊ]. 中國(guó)現(xiàn)代普通外科進(jìn)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.