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目的 探讨超声靶向微泡破裂(UTMD)内皮祖细胞(EPCs)移植干预大鼠慢性移植物血管病(CAV)的效果.方法 实验于2016年1月-2017年3月在四川大学实验室进行.选取成年雄性SD大鼠40只,随机分为4组:同种移植对照组(n=10),供、受体均为SD大鼠,无特殊处理;异种移植组(n=10):SD大鼠接受Lewis大鼠腹主动脉移植,尾部静脉注射生理盐水1 ml;EPCs组(n=10):实行异种移植,并于尾部静脉注射EPCs悬液1ml;UTMD+ EPCs组(n=10):实行异种移植,行体外UTMD处理后再经尾部注射EPCs悬液1 ml.移植60 d后取出移植血管,观察其组织病理学变化,测量内膜厚度,分别应用免疫组织化学法及Western blot法测定各组移植动脉增殖细胞核抗原(PCNA)、血管内皮生长因子(VEGF)及肿瘤坏死因子-α(TNF-α)表达水平.结果 同种移植对照组移植血管形态正常;异种移植组血管内膜明显较同种移植组明显增厚,呈移植物血管病表现;EPCs组与UTMD+EPCs组血管内膜厚度较异种移植组减少,而UTMD+ EPCs组血管内膜厚度较EPCs组减少(P均＜0.05).与异种移植组相比,EPCs组与UTMD+ EPCs组PCNA、VEGF TNF-α表达水平明显下降(P均＜0.05),且UTMD+ EPCs组PCNA、VEGF TNF-α表达水平低于EPCs组(t=7.114、6.230、2.196,P均＜0.05).结论 超声靶向微泡破裂可提高EPCs治疗CAV的效果,能更好地降低异体移植动脉PCNA、VEGF、TNF-α表达,可修复受损内膜,抑制CAV发生.“,”Objective To investigate the effect of ultrasound targeted microbubble rupture (UTMD) endothelial progenitor cells (EPCs) transplantation on chronic graft vascular disease (CAV) in rats.Methods Forty male SD rats were randomly divided into four groups:allograft control group (n =10),donor and recipient SD rats,no special treatment,xenograftgroup (n =10);EPCs group (n =10):xenotransplantation in the tail and intravenous injection of EPCs in the tail 1 ml;UTMD + EPCs group (n =10):the implementation of xenotransplantation,in vitro ultrasound destruction of microbubbles and then by tail injection of EPCs suspension 1 ml.(PCNA) and vascular endothelial cell factor (VEGF) were measured by immunohistochemistry and Western blotting respectively.The expression of PCNA,TNF-α,VEGF in the arterial cells were measured by immunohistochemistry and Western blotting.Results Transplanted vascular morphology of allograft control group was normal.The intima of the xenograft group was significantly thicker than allograft group.The VPCs group and the ultrasound microbubbles were used to control the thickness of the EPCs group.The thickness of endometrium in EPCs group and EPCs group was significantly lower than allograft group (EPCs group:t =35.204,UTMD + EPCs group:t =42.361,P ＜ 0.05),and the thickness of endometrium in EPCs group was lower than EPCs group (t =16.247,P ＜ 0.05).The expression of PCNA,VEGF TNF-α of EPCs group and UTMD + EPCs group were lower than xenograft group (EPCs group:t =11.325,t =6.472,t =7.843;UTMD + EPCs group:t =14.074,t =9.140,t =3.174,P ＜ 0.05).The expression of PCNA and VEGF TNF-α in UTMD + EPCs group was lower than that in EPCs group(t =7.114,t =6.230,t =2.196,P ＜ 0.05).Conclusion Ultrasound mediated microbubble destruction cari improve the effect of EPCs on CAV,and it can reduce the expression of PCNA,VEGF and TNF-α protein in allogeneic transplanted arteries,and can repair damaged intima and inhibit the occurrence of CAV.