摘要
目的探讨胰岛素对移植静脉进行处理是否保护缺血、再灌注的自体移植静脉血管内皮细胞。方法 32只杂种犬施行自体颈静脉-颈动脉移植术,术中将取出的移植静脉段分别浸入不同分组的处理液(每组8只):肝素生理盐水(vehicle)组(saline:0.9%NaCl;肝素12500U/L);GIK组(葡萄糖:250g/L;胰岛素:60U/L;KCl:80mmol/L;肝素12500U/L);GK组(葡萄糖:250g/L;KCl:80mmol/L;肝素12500U/L);GIK加渥曼青霉素(GIK+Wortmannin)组[处理液同GIK组,移植静脉再灌注前5min和后1～4h静脉注射渥曼青霉素2μg/(kg.min)]。术后4h获取移植静脉段进行凋亡蛋白caspase-3免疫组织化学测定和用末端脱氧核苷酸转移酶介导的dUTP原位平端标记法(TUNEL)定性和定量检测内皮细胞凋亡。结果与肝素生理盐水组相比,GK组增加移植静脉段内皮细胞和血管平滑肌细胞的凋亡(P<0.001),而GIK组则显著减少凋亡(P<0.001),渥曼青霉素则能有效抵抗胰岛素的抗凋亡作用。结论胰岛素对移植静脉段内皮细胞有保护作用,可能对移植静脉再狭窄有一定预防作用。
Objective This study was aimed at examining whether utilization of insulin exerted protective effect on the isehemie/ reperfused canine autologous vein graft. Methods Thirty - two mongrel dogs were subjected to jugular - carotid interposition bypass grafting, and underwent infusions of vehicle （saline, 0.9% NaCl;heparin, 12500U/L）, GIK （glucose, 250g/L; insulin, 60U/L; potassium, 80mmol/L; heparin, 12500U/L）, GK or GIK plus wortmannin [i. v, 2.0μg/（kg · min） for lb immediately after reperfusion] 5min before and 4h after reperfusion, respectively （ n = 8 in each group）. All dogs were euthanized at 4h postoperationally to harvest vein grafts. Apoptosis of endothelial cells （ECs） and vascular smooth muscle cells （VSMCs） in vein grafts were measured by active easpase - 3 immunohistoehemistry and TUNEL staining. Results Compared with vehicle, treatment with GK aggravated the apoptosis of ECs and VSMCs （ P 〈 0. 001 ）. However, treatment with GIK significantly decreased apoptosis of both ECs and VSMCs （ P 〈 0. 001 ）. Wortmannin largely abolished the GIK - elicited effects. Conclusion Insulin plays a protective role on autologous vein grafts, and likely prevents neointimal hyperplasia in autologous vein grafts.
出处
《医学研究杂志》
2010年第9期32-35,139,140,共6页
Journal of Medical Research
基金
国家自然科学基金资助项目(30571827)
关键词
移植静脉
再狭窄
胰岛素
凋亡
Autovenous grafts
Restenosis
Insulin
Apoptosis
