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目的 :探讨腔内血管成形术 (transluminalangioplasty ,TA)后再狭窄的预防方法。方法 :将 60支髂动脉 (3 0只家兔 )随机分为 3组 (每组 2 0支髂动脉 ) :水蛭组、丹参组和对照组 ,造成实验性动脉粥样硬化狭窄并进行TA后 ,水蛭组每天饲喂 2 g水蛭粉和普通饲料 ,丹参组每天饲喂 2 g丹参粉和普通饲料 ,对照组每天只饲喂普通饲料 ,3 0天后 ,进行血管造影和病理形态学检查。结果 :(1 )水蛭组髂动脉内膜厚度 (40 1± 9 8μm)显著小于丹参组 (48 2±8 2 μm)和对照组 (69 3± 9 2 μm) ,P <0 0 5。 (2 )TA后管腔狭窄度 ,水蛭组 (3 1 4% )和丹参组(48 4% )显著小于对照组 (62 8% ) ,P <0 0 5。 (3 )透射电镜观察表明 ,水蛭组和丹参组动脉内膜平滑肌细胞分化较好 ,细胞内粗面内质网较少 ,肌丝较多 ,而在对照组 ,平滑肌细胞内含有较多的粗面内质网 ,合成型平滑肌细胞较为多见。结论 :中药水蛭和丹参有抑制TA后血管平滑肌细胞增生 ,减轻内膜增厚 ,降低再狭窄发生率的作用 ,水蛭的效果更为显著。
Objective : To investigate the prevention of restenosis after transluminal angioplasty (TA). METHODS: Sixty radial arteries (30 rabbits) were randomly divided into 3 groups (20 brachial artery per group): Shuizhan group, Salvia miltiorrhiza group and control group, causing experimental atherosclerotic stenosis and after TA The Minamata group was fed with 2 g minced water and common feed every day. The Salvia miltiorrhiza group was fed with 2 g Danshen powder and common feed every day. The control group was fed only normal feed every day. After 30 days, angiography and pathomorphological examinations were performed. RESULTS: (1) The thickness of the radial artery intima (40 1 ± 9 8 μm) was significantly smaller in the blisters group than that in the Salvia miltiorrhiza group (48 2 ± 8 2 μm) and the control group (69 3 ± 9 2 μm), P <0 05. (2) After luminal stenosis, TA group (31%) and Salvia group (48%) were significantly smaller than those of control group (62%), P <00.5. (3) Transmission electron microscope observation showed that the intimal smooth muscle cells of Shuixie group and Salvia miltiorrhiza group were well-differentiated, with less intracellular rough endoplasmic reticulum and more myofilaments, whereas in control group, smooth muscle cells contained more rough Intracellular reticulum, synthetic smooth muscle cells are more common. Conclusion : Chinese medicine leech and salvia miltiorrhiza can inhibit the proliferation of vascular smooth muscle cells after TA, reduce the thickness of intima and reduce the incidence of restenosis. The effect of leech is more significant.