血管外支架保护下大鼠自体移植静脉TSG-6的表达及意义

发布时间：2018-04-26 11:10

  本文选题：TSG-6 + 桥血管　； 参考：《安徽医科大学》2017年硕士论文

【摘要】：目的:观察TSG-6(tumor necrosis factor alpha-stimulated gene-6)在大鼠移植静脉壁中的表达,探讨其作用及可能的机制,了解血管外支架、肿瘤坏死因子α(TNF-α)和白细胞介素-1(IL-1)对其表达的影响,为临床治疗移植后血管再狭窄提供新方向和理论依据。方法:安徽省动物中心供应的SPF级大鼠30只,雌雄不分,体重在270-330g,随机分成三组,即假手术组(JA)、支架保护组(ZA)和非支架保护组(WA),每组10只。JA组模型建立,游离大鼠右侧颈外静脉后,原位保留,缝合切口皮下组织及皮肤;WA组模型建立,采用袖套法(改良cuff法),取大鼠自体颈外静脉长约1.5cm,移植到同侧颈总动脉,建立血管移植模型;ZA组模型建立,在WA组手术操作中对移植静脉血管植入血管外支架(20G静脉留置穿刺针尾端输液管),预防移植血管的过度扩张。2周和8周后分别对ZA组和JA组行血管彩超检查,评估血管通畅情况。术后大鼠统一饲养,阿司匹林肠溶片10mg/kg/d灌胃,预防血栓形成。三组大鼠模型饲养12周,原切口切开取材。标本分两份,一份立即置于-80℃冰箱里冷冻,另一份以10%多聚甲醛固定。应用苏木精-伊红观察移植静脉内、中、外膜增生情况,采用计算机图像分析系统测量和计算各膜厚度;应用Western-blot检测移植静脉壁细胞内TSG-6、TNF-α和IL-1的表达。结果:30只大鼠无死亡,术后2周血管彩超各组动物模型血管通畅,血流速达15cm/s。术后8周血管彩超提示ZA组和WA组各有一只大鼠移植血管血流信号差,血管堵塞不通,总血管通畅率达93.3%。取材时肉眼观察:JA组血管与正常颈外静脉损伤血管无明显改变;ZA组血管支架外纤维组织包裹,受支架保护血管外膜较光滑,血管壁较JA组增厚;WA组血管囊袋状扩张明显,动脉搏动明显,外膜与周围组织有粘连,较ZA组血管壁增厚显著,WA组与ZA组相比较,内膜、中层、外膜增生分别达到1.5倍、1.7倍和1.8倍。HE染色显示,血管壁三层界限清晰WA组与JA组相比,血管壁各层增生明显,以中层为著;TSG-6在JA组中的表达比手术组(ZA组和WA组)中表达低;TSG-6在JA组中表达低于低于支架保护组P0.05,TSG-6在ZA组中表达低于WA组(P0.001);炎症因子TNF-α和IL-1的表达与TSG-6呈正相关,在ZA组的TNF-α和IL-1表达水平均显著低于WA组(P0.05)。结论:1)建立大鼠颈静脉移植动物模型,套管法简单、易操作;2)TSG-6、TNF-α、IL-1在大鼠静脉移植静脉血管壁细胞中存在表达;3)TSG-6与TNF-α、IL-1炎症因子一起参与血管的炎症反应和内膜增生;4)血管外限制性支架能有效抑制血管壁细胞增生,控制移植静脉的过度扩张,预防静脉血管壁细胞过度增生所致血管再狭窄。
[Abstract]:Objective: to observe the expression of TSG-6(tumor necrosis factor alpha-stimulated gene-6 in the vein wall of rats, and to investigate the effects of extracellular stents, tumor necrosis factor 伪 -TNF- 伪 (TNF- 伪) and interleukin-1 (IL-1) on the expression of TSG-6(tumor necrosis factor alpha-stimulated gene-6. To provide a new direction and theoretical basis for clinical treatment of vascular restenosis after transplantation. Methods: thirty SPF rats, male and female, weighing 270-330 g, supplied by Anhui Animal Center, were randomly divided into three groups: sham-operated group, stent-protected group and non-stenting protection group, with 10 rats in each group. After the right external jugular vein was free, the right jugular vein was preserved in situ, and the subcutaneous tissue and skin were sutured to establish the model of WA group. The cuff method (modified cuff method) was used. The length of the external jugular vein was about 1.5 cm, and transplanted to the ipsilateral common carotid artery. The model of blood vessel transplantation was established in group ZA. During the operation of WA group, 20 G vein indwelling catheter was inserted into the vein to prevent the excessive dilatation of the transplanted blood vessel at the end of 2 weeks and 8 weeks after the operation, the blood vessels in group ZA and group JA were examined by color Doppler ultrasound, respectively. To evaluate the patency of blood vessels. After operation, rats were fed with aspirin enteric-coated tablets (10mg/kg/d) to prevent thrombosis. Three groups of rats were fed for 12 weeks. The specimen is divided into two parts, one is immediately frozen in-80 鈩，

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