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目的:建立兔颈动、静脉移植血管桥动物模型,观察移植桥血管内膜增生和狭窄的电镜下表现。方法:通过兔双侧颈动脉进行动脉桥和静脉桥的移植,形成双侧移植血管桥再狭窄动物模型。在第8周施行血管桥移植手术的同时留取右侧颈动静脉标本作为对照血管,再分别于第12周、16周和第20周分别处死模型兔,采集移植桥血管标本,在光镜下测量其内膜厚度、面积、狭窄度,并进行电镜观察。结果:颈动脉和颈静脉桥移植后,随着时间的延长,桥血管的出现平滑肌迁移,脂质沉积,内膜增生,血管狭窄等改变,且以静脉桥血管的病理改变更为明显。结论:在兔形成动脉粥样硬化病变基础上,进行双侧颈动脉血管桥的移植,建立兔双侧颈动脉移植血管桥再狭窄动物模型,有利于设立自身对照,研究术后动静脉桥再狭窄差异机制;建立动、静脉桥后,位于血管中膜的平滑肌细胞出现向血管内膜迁移现象,说明中膜平滑肌细胞迁移进入内膜导致新内膜形成是血管再狭窄的重要环节。
OBJECTIVE: To establish a rabbit model of carotid artery and vein graft vascular bridge to observe the expression of vascular intimal hyperplasia and stenosis under the electron microscope. Methods: Transplantation of arterial and venous bridges through the bilateral carotid arteries of rabbits resulted in the formation of bilateral vascular graft restenosis. At the same time, the right carotid artery and vein specimens were taken as the control vessel at the 8th week after the vascular bridge transplantation. The model rabbits were sacrificed on the 12th week, the 16th week and the 20th week respectively. The vascular grafts in the graft were collected, The thickness, area and stenosis of the intima were measured and observed under electron microscope. Results: After the carotid and jugular vein grafts were bridged, the changes of smooth muscle, lipid deposition, intimal hyperplasia and vascular stenosis were observed with the passage of time. The pathological changes of venous bridge were more obvious. CONCLUSION: Bilateral carotid artery graft is transplanted on the basis of atherosclerotic lesion in rabbits and animal model of vascular bridge restenosis after bilateral carotid artery graft is established, which is propitious to establish self-control and to study the postoperative arteriovenous bridging Stenosis. After the establishment of arteriovenous and venous bridge, the smooth muscle cells located in the vascular medial membrane migrate to the intima, indicating that the migration of the mesangial smooth muscle cells into the endometrium leads to the formation of neointima, which is an important part of restenosis.