积雪草甙防治PCI术后再狭窄的实验研究

目的探讨积雪草甙防治经皮冠状动脉介入治疗(PCI)术后再狭窄的可行性。方法以球囊剥脱家兔髂动脉内膜后,用积雪草甙治疗4周,于造模及治疗4周后分别采血检测内皮素(ET)、一氧化氮(NO)、C反应蛋白(CRP),并光镜下观察髂动脉的形态学改变。结果家兔髂动脉球囊剥脱后ET、CRP升高,NO下降,与空白对照组相比有显著性差异(P均<0.001);光镜下见模型组血管内皮脱落,内弹力膜断裂,中膜部分断裂,外膜尚完整。积雪草甙治疗后,ET、CRP下降,NO升高,与病理对照组相比有显著性意义(P<0.05),并呈量-效关系;光镜下见内皮细胞覆盖,内膜基本修复,且高剂量组修复优于低剂量组。而病理对照组内皮细胞大部分脱落,内弹力膜断裂,部分伤及中膜,间质细胞大量增生。结论积雪草甙有促进内皮细胞生长、内膜修复的作用,初步提示其具有治疗PCI术后再狭窄的作用。

Experimental study of the effect of asiaticoside on preventing restenosis after percutaneous coronary intervention

Objective To investigate the feasibility of asiaticoside in preventing restenosis after percutaneous coronary intervention(PCI).Methods The rabbits' model of iliac arterial balloon injury was established and treated with asiaticoside for 4 weeks.The level of serum endothelin(ET),nitric oxide(NO) and C-reactive protein(CRP) was measured respectively and the pathological characteristics of iliac artery of rabbits were observed under light microscope.Results The serum ET and CRP obviously increased and the serum NO significantly decreased after the rabbits' iliac artery was peeled off by balloon injury(Compared~()with the control group,P<0.001).It was observed in the pathological section of the model group that the vas endothelium exfoliated,the tunica intima broke,the tunica middle broke partly and the tunica adventitia remained undamaged.Compared with the pathological control group,the serum ET and CRP decreased and the serum NO increased in asiaticoside group(P<0.05),and the dose-response relation was observed after treatment.Pathological section demonstrated that in the asiaticoside group vas endothelial cell had adhered into the arterial wall and the tunica intima was mostly restored,which is better in the high dose group than that in the low one;yet in the pathological control group most vas endothelial cells exfoliation,tunica intima disruption,part tunica middle damage and interstitial cell hyperplasia were observed.Conclusion Asiaticoside has an accelerating action on vas endothelial cell growth and tunica intima restoration.It is effective in the prevention of restenosis after PCI.