中国血液净化

中国血液净化 ›› 2021, Vol. 20 ›› Issue (08): 546-550.doi: 10.3969/j.issn.1671-4091.2021.08.010

• 基础研究 • 上一篇    下一篇

α-氰基丙烯酸酯血管外支架对兔动静脉内瘘近吻合口静脉内膜增生的影响

刘贤华1,焦自钊2,付海霞2,安传国2,张孝福2,王洪娟2   

  1. 济宁医学院附属日照市人民医院1血管外科2血液净化科
  • 收稿日期:2021-03-22 修回日期:2021-06-05 出版日期:2021-08-21 发布日期:2021-08-05
  • 通讯作者: 焦自钊 jiaozzrz@sina.com E-mail:jiaozzrz@sina.com
  • 基金资助:
    济宁医学院教师科研扶持基金项目(JYFC2019FKJ221)；日照市科技研发专项基金(KJYF2019289)

EEffect of α- cyanoacrylate extravascular stent on venous intimal hyperplasia in the juxta- anastomotic veins of arteriovenous fistula in rabbits

  1. 1Department of Vascular Surgery and 2Department of Blood Purification, the People’s Hospital of Rizhao City Affiliated to Jining Medical College, Rizhao 276826, China
  • Received:2021-03-22 Revised:2021-06-05 Online:2021-08-21 Published:2021-08-05

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摘要： 【摘要】目的观察α-氰基丙烯酸酯(α-cyanoacrylate,α-CA)血管外支架对兔动静脉内瘘(arteriovenous fistula,AVF)近吻合口静脉内膜增生的影响。方法取20 只成年雄性家兔，随机分为2 组，每组10 只。①对照组：颈总动脉、颈总静脉端端吻合建立AVF。②α-CA 组：AVF 建立后，近吻合口静脉外周表面应用α-CA 涂层建立血管外支架。分别于手术中、手术后1 月，彩色多普勒超声检测近吻合口静脉的内径及收缩期峰值血流速度，并于手术后1 个月取AVF 近吻合口静脉作如下检测：HE 染色测量其内膜厚度、内中膜厚度比值，免疫组化法检测其内膜增殖细胞核抗原(proliferating cell nuclear antigen, PCNA)、α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)的表达。结果AVF 手术后1 个月，彩色多普勒超声检测显示对照组AVF 近吻合口静脉内径[(3.50±0.30)mm]较α-CA 组[(3.22±0.23) mm]明显增加(t=2.326,P=0.032)；对照组AVF 近吻合口静脉收缩期峰值血流速度[(512.0±83.6)mm/s]较α-CA 组[(668.6±64.1) mm/s]明显降低(t=4,701,P＜0.001)。HE 染色显示对照组AVF 近吻合口静脉内膜厚度[(35.3±6.1)]μm 较α-CA 组[(24.8±5.6)μm]明显增加(t=3.987,P=0.001)；免疫组化法显示对照组AVF 近吻合口静脉内膜PCNA、α-SMA 的阳性率[(20.5±3.9)%、(25.9±4.7)%]明显高于α-CA组[(14.2±3.1)%、(16.5±3.7)%]，组间比较，差异均有统计学意义(t值分别为3.993、4.948，P值分别为0.001、<0.001)。结论α-氰基丙烯酸酯血管外支架能够减轻家兔颈总动静脉内瘘近吻合口静脉内膜增生。

关键词: 动静脉内瘘, 内膜增生, α-氰基丙烯酸酯, 血管外支架

Abstract: 【Abstract】Objective To observe the effect of extravascular stent coated with α-cyanoacrylate (α-CA) on venous intimal hyperplasia in juxta-anastomotic veins of arteriovenous fistula (AVF) in rabbits. Method Twenty adult male rabbits were randomly divided into control group (n=10) and α-CA group (n=10). AVF was created by end- to- end anastomosis of common carotid artery and common jugular vein in animals of both groups. In the α-CA group, extravascular stent coated with α-CA was applied to the outer surface of juxtaanastomotic vein. Color Doppler ultrasonography was used to examine the diameter and peak systolic flow velocity of the juxta-anastomotic vein immediately after the operation and after the operation for one month. The juxta- anastomotic vein was taken after the operation for one month, the intimal thickness and the ratio of intima/ media thickness were measured after hematoxylin-eosin (HE) staining, and the expression of proliferating cell nuclear antigen (PCNA) and α-smooth muscle actin (α-SMA) were detected by immunohistochemistry. Result After the operation for one month, color Doppler ultrasonography showed that the diameter of juxtaanastomotic vein of AVF was 3.50±0.30 mm in the control group higher than the diameter of 3.22±0.23 mm in the α-CA group (t=2.326, P=0.032); the peak systolic flow velocity in juxta- anastomotic vein of AVF was 512.0±83.6mm/s in the control group, lower than the velocity of 668.6±64.1mm/s in the α-CA group (t=4,701,P＜0.001). H-E staining of the intimal in the juxta-anastomotic vein showed that the intimal thickness was 35.3±6.1μm in the control group, higher than that of 24.8±5.6μm in the α-CA group(t=3.987, P=0.001). Immu-nohistochemistry of the intimal in the juxta- anastomotic vein showed that the positive expression rates of PCNA and α-SMA in the in intimal cells were 20.5±3.9% and 25.9± 4.7% respectively in the control group, higher than those of 14.2±3.1% and 16.5±3.7% respectively in the α-CA group (t=3.993 and 4.948 respectively, P=0.001 and <0.001 respectively). Conclusion Extravascular stent coated with α-cyanoacrylate can prevent
juxta-anastomotic vein of the AVF from intimal hyperplasia in rabbits.

Key words: Arteriovenous fistula, Intimal hyperplasia, α-cyanoacrylate, Extravascular stent

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