雌激素-胶原蛋白海绵对移植静脉再狭窄的影响及机制研究

发布时间：2018-06-25 14:06

本文选题：冠状动脉旁路移植术 + 非体外循环　；参考：《中国全科医学》2017年02期

【摘要】：背景自体静脉行冠状动脉旁路移植术后,桥静脉再狭窄发生率高,影响远期疗效。目的观察雌激素-胶原蛋白海绵在预防移植静脉再狭窄中的作用并探讨其可能机制。方法 2016年1—5月,选取雄性新西兰家兔80只,采用随机数字表法将家兔分为A~D共4组,各20只。建立颈外静脉-颈总动脉旁路移植动物模型,游离并取颈外静脉1.5 cm,将其两端倒置,分别与颈总动脉行端侧吻合。A组不进行特殊处理;B组采用胶原蛋白海绵敷于吻合口周围;C组以17β-雌二醇均匀涂抹于吻合口周围;D组将胶原蛋白海绵浸泡于17β-雌二醇溶液,然后敷于吻合口周围。分别于术后6 h及7、14、28 d各取5只家兔,完整取下桥静脉。每个标本选3个不同切面,计算机图像处理系统测量内膜、中膜厚度,采用Western blotting法检测增殖细胞核抗原(PCNA)、细胞外调节蛋白激酶1/2(ERK1/2)、磷酸化细胞外调节蛋白激酶1/2(p ERK1/2)表达水平。结果 C组、D组术后14、28 d桥静脉内膜厚度小于A组、B组,且D组术后14、28 d桥静脉内膜厚度小于C组(P0.05)。C组、D组术后14、28 d桥静脉中膜厚度小于A组,C组术后28 d及D组术后14、28 d桥静脉中膜厚度小于B组,D组术后28 d桥静脉中膜厚度小于C组(P0.05)。C组和D组术后6 h桥静脉PCNA表达水平低于A组、B组,C组术后7 d桥静脉PCNA表达水平低于A组、B组,D组术后7、14、28 d桥静脉PCNA表达水平低于A组、B组和C组(P0.05)。C组、D组术后6 h桥静脉p ERK1/2与ERK1/2比值低于A组、B组,C组术后7 d桥静脉p ERK1/2与ERK1/2比值低于A组、B组,D组术后7、14、28 d桥静脉p ERK1/2与ERK1/2比值均低于A组、B组和C组(P0.05)。结论雌激素用于自体移植静脉外膜可降低PCNA的表达水平和ERK1/2的活化,抑制细胞增殖和移植静脉内膜、中膜增生;胶原蛋白海绵具有缓释作用,提高了雌激素在局部的药物浓度,延长了药物的作用时间。
[Abstract]:Background the incidence of graft restenosis is high after coronary artery bypass grafting (CABG). Objective to investigate the effect of estrogen-collagen sponge on the prevention of vein graft restenosis and its possible mechanism. Methods from January to May 2016, 80 male New Zealand rabbits were selected and randomly divided into 4 groups, 20 rabbits in each group. An animal model of external jugular vein and common carotid artery bypass grafting was established. The external jugular vein was free and 1.5 cm, and the two ends were inverted. After end-to-side anastomosis with common carotid artery, group B was treated with collagen sponge applied to the perianastomotic area of anastomosis group C with 17 尾 -estradiol evenly applied to group D to soak collagen sponge in 17 尾 -estradiol solution. It is then applied around the anastomotic stoma. The inferior bridge vein was taken from 5 rabbits at 6 h and 14 28 d after operation respectively. The intima and media thickness were measured by computer image processing system. The expression levels of proliferating cell nuclear antigen (PCNA), extracellular regulated protein kinase 1 / 2 (ERK1 / 2) and phosphorylated extracellular regulated protein kinase 1 / 2 (pERK1 / 2) were detected by Western blotting method. Results the thickness of bridging vein intima in group C was less than that in group B at 1428 days after operation. And the thickness of graft vein intima in group D was less than that in group C (P0.05). Group D was smaller than group A at 1428 days after operation, and group D was less than group D on 28 days after operation, and group D was less than group D on 28 days after operation. The PCNA expression of bridging vein in group C was lower than that in group C (P0.05). The expression of PCNA in bridging vein of group D was lower than that in group A at 7 days after operation. The expression of PCNA in group C was lower than that in group A and group B at 7 days after operation. The expression of PCNA in bridging vein of group D was lower than that of group A at 71428 days after operation. The ratio of pERK1 / 2 / ERK1 / 2 in group D was lower than that in group A (P 0.05) and group C (P 0.05). The ratio of pERK1 / 2 / ERK1 / 2 in group C was lower than that in group A (P 0.05). The ratio of pERK1 / 2 / ERK1p2 in group D was lower than that in group A (P 0.05). Conclusion estrogen can reduce the expression level of PCNA and ERK1 / 2 activation, inhibit cell proliferation and intima hyperplasia of transplanted vein, collagen sponge has slow release effect. Increased the concentration of estrogen in the local drug, prolonged the drug's action time.
【作者单位】：滨州医学院附属医院心脏外科;
【分类号】：R654.3

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