| Objective:With the life extension of people and the change of diet, it has been found that arteriosclerosis obliterans (ASO) and acute embolism in artery of lower extremity for lower limbs of middle aged and aging people are common diseases in vascular surgery, which are the main reasons for amputation disability. They have become the serious diseases posing threaten on people'health. Percutaneous transluminal angioplasty (PTA) and Fogarty catheter embolectomy are the major ways of treating the ischemic disease. But the restenosis because of the intimal proliferation is the important factors influencing the patency rate after treatment, so it is urgent to find the prevention and treatment for the vascular intimal hyperplasia. By establishing the model of the endothelium damage of the femoral artery of rabbit, we observed the influences of low molecular weight heparin (LMWH) on the vascular intimal hyperplasia of rabbit and discussed its inhibition on the vascular intimal hyperplasia of rabbit after injuries.Methods:1.30 rabbits (weight 2.5-3.5kg, mean weight2.87kg):were as the research objects and were equally divided into 5 groups and each group had six ones:group A as the normal control group, group B as experimental group., group C as LMWH used (7 days after infection), group D as LMWH used (15 days after infection), group E as LMWH used (26 days after infection).2. Rabbits in the control group were given the normal diet, the rest of the rabbits were given the high fat and high-cholesterol diet. The groups except the control group 3 days after modeling were anesthetized by pentobarbital sodium 30mg/kg from the right femoral artery, the 4F balloon catheter dragged the iliac artery 8 times, resulting in the mechanical initial injury.800,000 u/day of penicillin were intramuscularly injected for 3 days, and the experiment groups were intravenously injected with bovine serum albumin by 250mg/kg, the control group was injected with saline.3. Group C, D, E 1 day after establishing the model of the nappy damage of the femoral artery were hypodermically injected with LMWH, Q12h, group C was continuously injected for 7 days, group D for 14 days, group E for 28 days, group B was continuously injected normal saline for 28 days.4. Lipids were detected 7,14,28 days before and after the high-fat diet. Lower artery angiography were used in groups C; D; E 28 days after operation. After they were killed, the iliac artery injured by surgery were taken, and observed by optical microscopy and electron microscopy.Result:1. Lipid changes:①there was no difference between group B and group A before the high-fat d.②there was a statistical significance in the lipid levels of group B compared with group A one week after high-fat diet;③The blood lipids tended to increase as the time of the high-fat diet extended.2. Results of optical microscopy:There was a statistical difference in the thickness of the vascular intimal hyperplasia among experiment groups (P<0.05). There was a statistical significance between the thicknesses of the vascular intimal hyperplasia of LMWH group compared with the experimental control group (P <0.05), indicating that LMWH had an inhibited influence on the membrane. The difference was statistically significant between group D and group C (P<0.05) and the difference was not statistically significant between group E and group D (P>0.05).3. Results of electron microscopy:The thicknesses of the vascular intimal hyperplasia of group C, D, E were less than the one of group B, the morphology of the smooth muscle cell was basically normal, and the number of the proliferating smooth muscle cell proliferation was little. VSMC became contractile, the cytoplasmic filaments were relatively more, the mitochondria and Golgi apparatus were relatively less. 4. Results of lower artery angiography:Group A was normal. Group B had an artery discontinuity, the distal femoral artery was not developing, the wall was not smooth, and the formation of collateral vessels was little. Group C had a significant artery stenosis and an artery discontinuity, it is showed that collateral vessels appeared dense, distributing reticularly and connecting between the interruption of the femoral artery. The iliac artery of Group D became thin, the walls of injured artery were not smooth, with a small filling defect and a collateral vessel formation. The artery of Group E became thin, the continuity was sound, the contrast agent went through well, and the arterial wall injured was not smooth, there was less formation of collateral vessels in Group E compared with the ones in C, D group.Conclusion:The blood lipids tend to increase with the time extension of the high-fat diet. LMWH can prevent endometrial hyperplasia effectively after endothelial injury, but it has a little inhibition effect on the intimal hyperplasia 14 days after the continuous treatment, especially in the period of the early injury treatment. It is found that LMWH can play an important role in the pathological process of vascular endothelial hyperplasia after balloon injury restenosis, which provides a new theory and method for the prevention and treatment of restenosis. |
PDF Full Text Request