麝香保心丸抑制兔腹主动脉支架植入后再狭窄的形成_主动脉狭窄三联征

　　【摘要】 目的 观察麝香保心丸抑制兔腹主动脉支架植入后支架再狭窄的形成。方法 实验于2005～02/12在郑州大学人民医院心内科实验室进行。取36只健康的新西兰雄性大白兔数字表法随机分为单纯高脂饮食组、对照组和麝香保心丸组3组(n=12)。3组均饲以含15 g/L胆固醇的高脂饮食，对照组和麝香保心丸组高脂喂养3 d后行腹主动脉内皮剥脱术。术后第10周该两组的24只兔行腹主动脉二维超声、彩色多普勒、脉冲多普勒观察。一旦超声检查证实腹主动脉形成≥50%狭窄，对照组与麝香保心丸组均开始服用辛伐他汀5 mg/d，阿司匹林片25 mg/d，氯吡格雷125 mg/d。麝香保心丸组加服麝香保心丸3次/d，每次2丸，服药至第8天，对照组和麝香保心丸组在腹主动脉≥50%狭窄部位植入支架,行支架植入术35 d后，复查腹主动脉造影。结果 经补充后36只兔均进入结果分析。①高脂饮食联合动脉内膜剥脱较单纯高脂饮食血脂各项升高更明显(P<005)。②血管造影显示高脂饮食联合动脉内膜剥脱术的所有兔的动脉粥样硬化狭窄均形成，目测狭窄程度在50％～70%［(57000±7888)％］，狭窄长度8～23 mm。③兔腹主动脉造影检查结果提示再狭窄只数麝香保心丸组与对照组相比明显减少(P<005)。结论 麝香保心丸可能通过抑制平滑肌细胞的移动减少支架内新生内膜的行成从而具有预防支架植入后再狭窄的作用。
　　【关键词】 麝香保心丸；平滑肌细胞；支架再狭窄，兔；内皮剥脱术
　　To investigate the effect of Shexiang Baoxin Wan(SXBXW) preventing instent restenosis after stenting in abdominal aorta of rabbits YU Jie, GAO Chuanyu, XU Wenke, ZHANG Lianzhong Medicine Section Department of Gerontology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052,China
　　【Abstract】 Objective To investigate the effect of Shexiang Baoxin Wan(SXBXW) preventing restenosis after stenting in abdominal aorta of rabbitsMethods The experiment was carried out in the laboratory of Department of Cardiovascular Medicine, the Peoples Hospital of Zhengzhou University from February to December 200536 male New Zealand white rabbits were randomly divided into highfat diet, control group and SXBXW group with 12 rabbits in each group The 3 groups were given a cholesterolrich diet containing 15 g/L cholesterol, 3 days later, the rabbits of control group and SXBXW group were subjected to balloon injury of abdominal aorta from femoral approachAt the 10th week after operation, the 24 rabbits were observed by twodimensional ultrasound, color Doppler and pulse Doppler of abdominal aorta, once the stenosis ≥50% was found proved by ultrasonographic image, rabbits of the two groups began to take simvastatin (5 mg daily)，aspirin(25 mg daily)，clopidogrel(125 mg daily) SXBXW group were also given SXBXW, (6 pills daily) Eight days later, stents were implanted on the segment of stenosis of the SXBXW and control groups instructed by digital subtraction radiography Thirtyfive days later, angiography were used to record the degree of stenosis of the abdominal aorta after operationResults All the 36 rabbits were involved in the result analysis after supplement ①After 9 weeks,the levels of TC,TG,HDL,LDL were increased,which was more obviously in the highfat diet combined with arterial injury groups②Stenosis of abdominal aorta was observed at the 10th week by angiography and the rate of stenosis was 50%～70% ［(57000±7888)%］ and it was 8～23 mm in length ③Rabbits which were instent restenosis of abdominal aorta in SXBXW group were obviously less than the rabbits in control group by angiography (P<005) Conclusion SXBXW may prevent the restenosis after stenting in abdominal aorta of rabbits by inhibiting the movement of smooth muscle cell to neointima。