放疗抑制重建术后人工血管新生内膜的实验研究

doi:10.3969/j.issn.1006-7795.2015.01.007

首都医科大学学报 ›› 2015, Vol. 36 ›› Issue (1): 34-39.doi: 10.3969/j.issn.1006-7795.2015.01.007

放疗抑制重建术后人工血管新生内膜的实验研究

袁丽琴¹, 舒畅², 周晓³, 张文波², 方坤², 李鑫², 李全明²

1. 中南大学湘雅二医院普通外科, 长沙 410011;
2. 中南大学湘雅二医院血管外科, 长沙 410011;
3. 中南大学湘雅医学院附属肿瘤医院头颈外科, 长沙 410013

收稿日期:2014-11-15 出版日期:2015-02-21 发布日期:2015-01-31
通讯作者: 舒畅 E-mail:changshu01@yahoo.com
基金资助:
国家自然科学基金(81370430).

Radiation suppresses neointimal hyperplasia after revascularization

Yuan Liqin¹, Shu Chang², Zhou Xiao³, Zhang Wenbo², Fang Kun², Li Xin², Li Quanming²

1. Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha 410013, China;
2. Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, Changsha 410013, China;
3. Department of Head and Neck Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China

Received:2014-11-15 Online:2015-02-21 Published:2015-01-31
Supported by:
This study was supported by National Natural Science Foundation of China (81370430).

摘要/Abstract

摘要： 目的构建膨体聚四氟乙烯(expanded polytetrafluoroethylene,ePTFE)人工血管置换杂种犬肾动脉平面下腹主动脉的血管重建手术模型.探讨总剂量28Gy的体外分割放射治疗影响重建术后人工血管内膜增生的机制.方法健康杂种犬12只,采用数字表法随机均分成放疗组和对照组.均先行肾下腹主动脉段的人工血管置换重建术.放疗组于术后2周后对标记区血管行总剂量28Gy的体外放疗.对照组则不放疗.重建术后5周观察比较两组移植术后的人工血管新生内膜的增生情况,Skp2、p27^kip1和增生细胞核抗原(proliferating cell nuclear antigen,PCNA)的蛋白和mRNA的表达情况.结果放疗组的人工血管吻合口内膜增生程度明显比对照组降低(P<0.01).放疗组的Skp2、PCNA的蛋白表达及mRNA表达较对照组明显减低, 而p27^kip1的mRNA表达较对照组明显增加(P<0.01).结论术后体外分割放疗(28Gy)在短期内可以通过抑制血管平滑肌细胞(vascular smooth muscle cell, VSMC)的增生,从而抑制重建术后的人工血管的内膜增生.

关键词: 人工血管, 放疗, 内膜增生, Skp2, 增生细胞核抗原, p27^kip1

Abstract: Objective To study the effect of postoperative fractionated X-ray radiotherapy, at a total dose of 28 Gy, on neointimal formation and strive to further elucidate the mechanisms of neointimal hyperplasia in the abdominal expanded polytetrafluoroethylene (ePTFE) prosthetic vascular graft. Methods The subrenal abdominal aortas of 12 mongrel dogs were replaced with an ePTFE graft. The dogs were randomly divided into either a radiotherapy group or a non-radiotherapy control group. Grafts were harvested at five weeks after surgery for comparing the thickness of neointimal formation and the expression of PCNA, S phase kinase associated protein 2 (Skp2) and p27^kip1 in the two groups.Results We observed that the graft neointimal and anastomotic vessel wall of the radiotherapy group were significantly thinner than those of the control group (P<0.01). The mRNA and the protein expression of p27^kip1 was elevated in the neointimal area after irradiation (P<0.01). The mRNA and the protein expression of PCNA and Skp2 were significantly down-regulated in the radiotherapy group (P<0.01). Conclusion Postoperative fractionated radiotherapy(28 Gy)after an ePTFE graft replacement of the abdominal aorta suppressed the development of neointimal hyperplasia and the proliferation of vascular smooth muscle cell (VSMC) in the graft in the short term.

Key words: expanded polytetrafluoroethylene, radiation, neointimal hyperplasia, Skp2, proliferating cell nuclear antigen, p27^kip1

中图分类号:

R622

袁丽琴, 舒畅, 周晓, 张文波, 方坤, 李鑫, 李全明. 放疗抑制重建术后人工血管新生内膜的实验研究[J]. 首都医科大学学报, 2015, 36(1): 34-39.

Yuan Liqin, Shu Chang, Zhou Xiao, Zhang Wenbo, Fang Kun, Li Xin, Li Quanming. Radiation suppresses neointimal hyperplasia after revascularization[J]. Journal of Capital Medical University, 2015, 36(1): 34-39.

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放疗抑制重建术后人工血管新生内膜的实验研究

Radiation suppresses neointimal hyperplasia after revascularization

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