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目的 为了更好地研究静脉再狭窄的机制及预防治疗 ,建立一种人的大隐静脉体外培养模型 ,并对新内膜进行初步研究。 方法 取 6例冠状动脉旁路移植手术患者大隐静脉 ,体外培养 14天 ,常规病理学染色 ,图象分析 ;通过α-平滑肌细胞骨架 (α- actin)免疫组织化学染色方法检测内膜增生细胞 ,末端脱氧核苷酸转移酶介导的 d UTP缺口末端标记 (TUNEL)方法检测内膜凋亡细胞。 结果 培养的大隐静脉在 14天后有新内膜形成和显著的中膜增厚 ,与正常血管相比差别具有显著性意义 (P<0 .0 1)。新内膜细胞α- actin免疫组织化学染色结果呈阳性细胞 ,较正常血管内膜明显增多。在新内膜中荧光和核边聚分裂数目极少 ,与正常血管相比差别无显著性意义。 结论 在人的大隐静脉体外培养中有新内膜形成和中膜增厚 ,增生的细胞可能是肌成纤维细胞 ,故抑制肌成纤维细胞增生迁移的同时 ,促进凋亡将是静脉移植血管病变潜在的治疗方法。
Objective To study the mechanism of venous restenosis and preventive treatment, a human saphenous vein in vitro model was established and the neointima was studied. Methods The saphenous veins of 6 patients undergoing coronary artery bypass grafting were cultured in vitro for 14 days and analyzed by routine pathology and image analysis. Intimal hyperplasia cells were detected by α-actin immunohistochemical staining , Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) method was used to detect apoptotic cells in the endometrium. Results The saphenous veins in culture showed neointima formation and significant intimal thickening after 14 days, which was significantly different from normal vessels (P <0.01). Neointima cells α-actin immunohistochemistry staining positive cells, compared with normal intima significantly increased. In the neointima, the number of fluorescence and nuclear edge-splitting is very small, which has no significant difference compared with normal blood vessels. Conclusion In vitro culture of human saphenous vein with neointima formation and intima-media thickening, hyperplastic cells may be myofibroblasts, so inhibition of proliferation and migration of myofibroblasts, while promoting apoptosis will be vein graft vessel Potential treatment of disease.