超声介导下球囊拉伤对兔腹主动脉管径扩张和新生内膜增生的影响

摘要

目的 评价超声介导下球囊拉伤时不同充盈压力对主动脉管径扩张和新生内膜增生的影响.HTH方法 超声测量新西兰大白兔腹主动脉特定靶节段的初始管径,选择15只管径相近的兔子在超声监测下行球囊拉伤术,并根据球囊充盈压力不同,随机分为三组,充盈压分别为1个大气压(atm),5atm和10atm,超声记录手术前、后不同组别血管内径的变化.术后2周猝死动物,观察新生内膜增生情况.结果 当球囊位于兔腹主动脉靶节段并以1atm充盈时,球囊在所有兔子中均充分扩张,贴合管壁,无血流信号通过.当以不同充盈压拉伤血管后,每组动脉管腔均显著扩张(P<0.05),但三组的管径扩张率相似;1atm组的动脉新生内膜面积比和周长比明显小于其他两组(P<0.05),但最大新生内膜厚度比随充盈压增加明显增大,各组间均存在显著差异(P<0.05).结论 在球囊充分扩张前提下,不同充盈压引起管径扩张程度相似,但较小充盈压引起较轻的新生内膜增生.%Objective To evaluate the influence of different inflation forces on artery diameter and neointima hyperplasia via ultrasound-guided balloon injury.MethodsWTBZ New Zealand white rabbits were assigned into three groups randomly with the inflation force at 1,5,10 atmosphere pressure (atm).The anteroposterior diameter (DAP) of the target segment of aorta in all rabbits was measured by ultrasound imaging (US) to ensure the similar original diameter in three groups.Then balloon dilation and injury of aorta were performed guided by US.All rabbits were euthanized 2 weeks later for histologic evaluation.Results When the balloon was localized at the target segment and inflated with 1atm,the balloon expanded sufficiently with no color flow signal shown in all rabbits.After balloon injury,the lumen size of each group enlarged significantly (P<0.05) with the similar rate of change in DAP.Both neointima area and circumference in group with 1atm were significantly less than those of the other two (P<0.05).Maximal neointima thickness increased significantly with the elevation of the inflation pressure among the three groups (P<0.05).Conclusion When the balloon was dilated sufficiently,the balloon inflated with the less pressure caused the similar vascular dilation as the high pressure but the less neointima proliferation.