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Ultrastructural and pathophysiologic characteristics of late occlusion of arterially implanted autovein grafts and its medical control

动脉植入自血管移植物晚期闭塞的超微结构和病理生理特征及其医学控制

基本信息

批准号：
05454358
负责人：
KUSABA Akira
金额：
$ 3.65万
依托单位：
University of the Ryukyus
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1993
资助国家：
日本
起止时间：
1993 至 1994
项目状态：
已结题

项目摘要

1. Ultrastructural and pathophysiologic features of intimal hyperplasia of the arterially implanted autovein graft and its anastomosis under conditions of poor distal runoff were investigated. The graft was degenerated within 5 days after grafting and intimal hyperplasia of the graft was evident and diffusely labelled with BedU at 14 days. Intimal hyperplasia of the graft and its anastomosis increased to about 500 mum with proliferation of myofibroblasts in the graft and fibroblast-like cells at the anastomosis at 6 months. Cells in the superficial layr of the neointima were scarcely labelled with BrdU,but cells in the deeper layr were strongly labelled with BrdU.Cell proliferation of the neointima of the graft and its anastomosis was progressive at the deeper layr of the neointima even at 6 months after grafting.2. Distribution of collagen in types I,III,and IV and fibronectin was evident in the subendothelial layr of the neointima of the graft implanted under conditions of normal dis … More tal flow, but those in the neointima of the graft implanted under conditions of poor distal runoff were diffusely distributed in the neointima without accumulation in the subendothelial layr.3. Development of luminally originating capillary vessels in the proliferated neointima at the distal end-to-side anastomosis of the arterially implanted autovein graft was investigated. Creft of the vascular wall was formed along the suture material and it was covered with endothelial cells within 5 days after grafting. Many luminally originating capillary vessels were found along the suture line and distributed into the proliferated neointima forming capillary network 3 to 6 months after grafting.4. In the cell cuture system of endothelial cells and smooth muscle cells, proliferation of cells was actively stimulated by addition of serum and endothelial mitogen. Cell proliferation of endothelial cells and smooth muscle cells was inhibited significantly by TGF-beta_1 and moderately by berapamil. Clinical dosis of steroid, PG E_1, and argadroban was not effective for inhibition of cell proliferation in the cell culture system. Effects of other vasoacting agents on the inhibition of cell proliferation should be investigated. Less

1. 研究了在远端径流不佳的情况下，动脉植入自体静脉移植物及其吻合的内膜增生的超微结构和病理生理特征。移植后5 d内移植物变性，14 d时移植物内膜增生明显，弥漫性BedU标记。6个月时，移植物及其吻合口的内膜增生增加至约500 μ m，移植物中肌成纤维细胞和吻合口的成纤维细胞样细胞增生。新生内膜浅层细胞BrdU标记较少，而较深层细胞BrdU标记强烈。移植后6个月，血管内膜及吻合口的细胞增殖在血管内膜较深层仍呈进行性。正常血流状态下，移植血管新生内膜的I、III、IV型胶原和纤维连接蛋白分布明显，血流较多，但远端血流差的移植血管新生内膜中的胶原弥漫性分布在新生内膜中，未在内皮下积聚。观察了自体动脉植入术远端端侧吻合处增生新生内膜中光源性毛细血管的发育情况。在移植后5天内，沿缝合线材料形成血管壁沟，并被内皮细胞覆盖。3 .移植后3 ~ 6个月，沿缝合线发现许多发光毛细血管分布到增生的新生内膜形成毛细血管网。在内皮细胞和平滑肌细胞的细胞培养系统中，添加血清和内皮细胞有丝分裂原可积极刺激细胞增殖。tgf - β 1对内皮细胞和平滑肌细胞的增殖有显著抑制作用，贝拉帕米对内皮细胞和平滑肌细胞的增殖有中度抑制作用。在细胞培养系统中，临床剂量类固醇、PG E_1和阿加德罗班对细胞增殖的抑制效果不明显。其他血管作用剂对细胞增殖的抑制作用有待进一步研究。少