Expression And Significance Of VEGF And CD34 In Blood Vessel And Surrouding Tissue By Different Sclerosing Agent Injection

Aims : Esophageal varices bleeding is a serious complication of hepatic cirrhosis portal hypertension , its dangerous condition. endoscopic variceal sclerotherapy was the major rescue measures for treatment of esophageal varices bleeding. Sclerosing agent have a great variety in market, in order that the efficacy, side effects and repeat times for treatment after different sclerosing agent injection, this study utilize the animal vein and surrounding tissue specimens after different sclerosing agent injection, through the immunohistochemical evaluatation of VEGF and CD34 in the scorresponding expression of vascular and organizations, to observe the impact of blood vessels and surrounding tissue after different sclerotherapy, and tissue repair, so as to the choice of relatively ideal scleroing agent, repeat the treatment time to provide a theoretical basis.Methods: The different sclerotherapy animal vein and the surrounding tissue specimens from the completed animal experiment. Select weight of about 2-3Kg of rabbits whose sex was no limited, were randomly divided into five groups, 1% aethoxysklerol group (n=8), absolute alcohol group (n=8), 5% sodium morrhuate group (n=8), thrombin group (n=8), normal sodium control group (n=4). Every experimental group was separated into the intravenous injection group, the other was the intravenous and paravenous joint injection group. Select the ear vein and surrounding tissue after different scleroing agent injection. In 1^st day, 3^rd days, 7^th days, 14^th days after injection laboratory animals were sacrificed for different sclerosing agent injection group, the veins and surrounding tissue were carry out conventional HE staining and immunohistochemistry detected expression of VEGF and CD34, to evaluate the curative effects, side effects, and tissue repair time in different group.Results: HE staining showed that the vascular endothelial and surrounding tissue after three sclerosing agent injection have a varying degree injury, of which the most absolute alcohol, followed sodium morrhuate, aethoxysklerol lightest, and thrombin group and the normal sodium control group was no significant difference. VEGF using integral evaluation, CD34 use MVD count evaluation, both in the aethoxysklerol group showed significantly higher trend, the 3^rd day reached a peak, 7^th -14^th day decreased gradually to normal, two injecting style no obvious differences (VEGF for P=0.199, MVD for P=0.632), the contrast between the periods P<0.05; VEGF and MVD in the absolute alcohol group showed significantly downward trend, to 7^th and 14^th day almost zero, comparison between the two injecting style have a significant difference (VEGF and MVD both P<0.05), the joint injection lower, the contrast between the periods P<0.05; VEGF and MVD in sodium morrhuate group performances for the light increased then obvious downward trend, there are no significant difference between two injection (VEGF for P=0.184,MVD for P=0.549), the contrast the periods P<0.05; In thrombin group, VEGF and MVD no significant difference (VEGF for P=0.913,MVD for P=0.256), there is no difference between the various time slots (VEGF for P=0.069,MVD for P=0.08); VEGF score and MVD count contrast in the sclerosing agent groups and anyone with thrombin or normal sodium control group have significant differences, all P<0.05; There was no significant contrast between thrombin and normal sodium, P>0.05.Conclusions: According to pathological changes seen from HE staining, as well as the expression of VEGF and CD34 in animal tissue specimens after different scleroing agent injection, HE staining showed 1% aethoxysklerol have some characteristics, such as blood vessels and tissue injury small, thrombosis fast and organizations recovery quick. VEGF and CD34 expression in 3^rd day reach summit, two weeks later return to normal, confirmed that it is a more ideal sclerosing agent, but the price is more expensive, proposed joint injection treatment in larger vessels, the treatment cycle about 1 week; HE staining showed Absolute alcohol have some feature that thrombosis fast , tissue injury large and tissur repair slow, VEGF and CD34 expression were consistent, in 3^rd day decreased significantly, 7^th - 14^th day almost no expression, suggesting that its should not be used as clincical application of conventional sclorsing agent to treatment esophageal varices, even if we use, it should be to the mian intravenous injection, the treatment cycle should be over in two weeks. HE staining showed 5% sodium morrhuate have good embolization results, but the blood vessels and surrounding tissue injury more serious than aethoxysklerol, VEGF and CD34 expression showed the process of mild rise then significantly decreased, tissue repair between aethoxysklerol and absolute alcohol, but its low price, there is still space for clinical application, the joint injection style was recommendation, the treatment cycle in one week above. Thrombin injection and normal sodium control group have same effect, no aseptic inflammation, thrombosis can not be formed , VEGF and CD34 expression no change, don't have to use as a sclerosing agent.