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目的探讨冠脉内支架置入后局部内膜增生的情况和血管紧张素Ⅱ1型受体的演变。方法建立冠状动脉支架置入的微型猪动物模型。分别于支架置入后3、7、28、90和180d截取支架段血管连同临近的近端正常血管段,通过病理组织学分析和PCR技术检测支架局部内膜增生和血管紧张素Ⅱ1型受体mRNA水平的演变情况。结果正常血管段表达AT1R-mRNA在各个时间段没有显著性差异。支架置入后3d局部血管壁AT1R-mRNA的表达明显增高,并在术后28d达到高峰。术后90dAT1R-mRNA的表达呈现下降的趋势,但仍显著高于正常血管段,且差异一直持续到术后180d。术后第3天支架段血管壁内膜加中膜面积与普通血管段相比没有显著差异。到术后7d支架血管段内膜加中膜面积已显著大于正常血管段,并随时间呈现持续的增生肥厚。在术后180d达到高峰。结论支架置入后局部血管壁AT1R-mRNA呈现持续的高表达状态,在局部内膜持续过度的增生中起重要的作用。
Objective To investigate the situation of local intimal hyperplasia and the change of angiotensin Ⅱ type 1 receptor after intracoronary stent implantation. Methods The miniature swine animal model of coronary stent implantation was established. At 3, 7, 28, 90 and 180 days after stent implantation, the vessel segments of the stent segment were taken together with the adjacent proximal normal blood vessel segments. The histological and PCR techniques were used to detect the local intimal hyperplasia and angiotensin Ⅱ type 1 receptor The evolution of mRNA levels. Results The expression of AT1R-mRNA in normal blood vessels showed no significant difference at different time points. The expression of AT1R-mRNA on the local vessel wall was significantly increased 3 days after stent implantation and peaked at 28 days after stent implantation. After 90 days, the expression of AT1R-mRNA showed a downward trend, but still significantly higher than normal blood vessels, and the difference continued until 180 days after surgery. There was no significant difference in the intima-media area of the vessel wall in the stent segment on the 3rd day after operation compared with the common segment. At 7 days after operation, the intima-media area of the vessel segment of the stent was significantly larger than that of the normal vascular segment, and showed continuous hyperplasia over time. After 180d peak. Conclusion The expression of AT1R-mRNA in local vascular wall after stent implantation continues to be highly expressed, which plays an important role in the persistent hyperplasia of endometrium.