INFLUENCE OF VEIN VALVES IN THE DEVELOPMENT OF ARTERIOSCLEROSIS IN VENOARTERIAL GRAFTS IN THE RABBIT
INFLUENCE OF VEIN VALVES IN THE DEVELOPMENT OF ARTERIOSCLEROSIS IN VENOARTERIAL GRAFTS IN THE RABBIT
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DOI：
10.1016/s0022-5223(95)70061-7
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发表时间：
1995-11-01
影响因子：
6
通讯作者：
MATLOFF, JM
中科院分区：
文献类型：
--
作者：
CHAUX, A;RUAN, XM;MATLOFF, JM
人冠状大隐静脉移植物的长期通畅率比胸廓内动脉移植物更有限，主要是因为动脉硬化发展更快。导致这种易感性增加的因素还不完全清楚。为了验证静脉瓣膜可能影响这一过程的假设，我们研究了48只高胆固醇血症家兔，颈静脉移植物插入颈动脉循环。在24只动物（A组）中，静脉段不含静脉瓣膜。在其他24只动物（B组）中，存在静脉瓣膜。两组再分为4个亚组，每组6只，分别于术后2、4、6、8周处死。所有动物均饲喂2%胆固醇饲料。在尸检时，交替的2 mm切片用苏木精和伊红染色用于组织学和形态学研究，或冷冻在液氮中用于免疫组织化学和原位杂交研究，增殖细胞核抗原免疫染色用于研究细胞增殖。移植静脉壁厚度随着时间的推移而增加。在前2周，内膜和中膜增厚主要是由于细胞数量的增加。在2周和6周之间，发生了进一步的内膜和中膜增厚，但细胞数量没有额外增加。6周后开始出现泡沫细胞和脂质沉积。到8周时，与在人类动脉粥样硬化斑块中观察到的变化相同的变化是明显的。这些变化在B组动物中发展得更快，强度更大（p < 0.01至0.001），位于瓣膜远端的静脉节段比位于瓣膜近端的静脉节段发展得更快，严重程度更高（p < 0.001）。这是第一个对照实验，证明静脉段中存在瓣膜与导致静脉动脉粥样硬化的内膜变化增加和加速相关。
Coronary saphenous vein grafts in human beings have a more limited long-term patency rate than internal thoracic artery grafts, primarily because of more rapid development of arteriosclerosis. The factors responsible for this increased susceptibility are not completely understood. To test the hypothesis that vein valves may influence this process, we studied 48 hypercholesterolemic rabbits with jugular vein grafts interposed into the carotid arterial circulation. In 24 animals (group A), the vein segments did not contain a vein valve. In the other 24 animals (group B), a vein valve was present. Both groups were further divided in four subgroups of six to be put to death at 2, 4, 6, and 8 weeks after the operation. All animals were fed a 2% cholesterol diet. At postmortem examination, alternate 2 mm sections ,were either stained with hematoxylin and eosin for histologic and morphometric studies or frozen in liquid nitrogen for immunohistochemistry and in situ hybridization studies, proliferating cell nuclear antigen immunostaining was used to study cell proliferation. Wall thickness of vein grafts increased with time. During the first 2 weeks intimal and medial thickening was primarily due to an increase in numbers of cells. Between 2 and 6 weeks further intimal and medial thickening occurred, but without additional increase in cell numbers. After 6 weeks, foam cells and lipid deposits started to appear. By 8 weeks, changes identical to those seen in arteriosclerotic plaques in human beings were evident. These changes developed sooner and with more intensity in group B animals (p < 0.01 to 0.001), and they developed faster and with more severity in segments of vein located distal to the valve than in the segments located proximal to the valve (p < 0.001). This is the first controlled experiment demonstrating that the presence of valves in the vein segments is associated with augmented and accelerated intimal changes leading to vein atheromatosis.