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目的 :通过表阿霉素涂膜金属内支架在正常家猪门静脉中的应用 ,评价带药支架在门静脉系统的急性血栓形成 ,炎症反应 ,异物反应和血管内膜增生程度。方法 :10头正常家猪均分为实验组和对照组。经皮穿肝行门静脉造影并测量门静脉直径 ,实验组置入带药金属内支架 ,对照组为金属裸支架 ,重复测量门静脉直径。 2组配对分别于术后 4d、1周、2周、4周、6周处死动物 ,处死前行门静脉造影并测量门静脉直径。门静脉标本行病理检查和透射电镜检查。结果 :实验组 4d未发生急性血栓 ,对照组 4d发生血管壁部分急性血栓 ;实验组 4周、6周门静脉直径分别为支架置放即刻的 88.9%和 87.5 % ,对照组 4周和6周为自身的 6 0 %和 5 0 %。术后 1～ 6周实验组均可见血管壁出血并呈逐渐加重 ,炎症细胞浸润 ,异物巨细胞出现 ,血管壁小血管增生 ,中膜增生不明显 ;对照组术后 2～ 6周主要表现中膜增生改变为主 ,血管壁亦有出血改变 ,血管壁小血管增生较实验组明显 ,炎症细胞浸润较轻 ,弹力纤维增生明显 ,管腔变窄。实验组 1～ 6周电镜显示胶元纤维排列整齐 ,增生不明显 ,内皮细胞较完整 ,未见明显破坏 ,平滑肌细胞部分破坏 ,细胞核染色变深 ,胞浆内脂质增多。成纤维细胞和平滑肌细胞未见明显增生。对照组电镜下可见成纤维细胞代谢活?
OBJECTIVE: To evaluate the acute thrombosis, inflammatory reaction, foreign body reaction and intimal hyperplasia of portal vein with drug-eluting stent through the application of epirubicin-coated metal stent in the portal vein of normal domestic pigs. Methods: 10 normal domestic pigs were divided into experimental group and control group. Percutaneous transhepatic portosystemic angiography and portal vein diameter were measured. The experimental group was implanted with drug-metal stent, the control group was bare metal stent, and the diameter of portal vein was measured repeatedly. The rats in two groups were sacrificed at 4 days, 1 week, 2 weeks, 4 weeks and 6 weeks after operation, and the portal vein angiography was performed before the portal vein diameter was measured. Portal vein specimens were examined by pathology and transmission electron microscopy. Results: In the experimental group, no acute thrombus occurred on the 4th day, and the acute vessel thrombosis was observed on the 4th day in the control group. The diameters of the portal vein in the experimental group at 4 and 6 weeks were 88.9% and 87.5% Own 60% and 50%. 1 to 6 weeks after operation, all the experimental group showed hemorrhage of vascular wall and gradually increased, infiltration of inflammatory cells, appearance of giant cells of foreign body, small vessel hyperplasia of vessel wall, and no obvious hyperplasia of medial membrane. In the control group, the main manifestations were 2 to 6 weeks after operation Membranous hyperplasia was the main alteration, and hemorrhage was also observed in the vessel wall. Small vessel hyperplasia in vessel wall was more obvious than experimental group. Inflammatory cell infiltration was lighter, elastic fiber hyperplasia was obvious and lumen narrowed. The experimental group 1 to 6 weeks electron microscopy showed collagen fibers arranged in neat rows, hyperplasia was not obvious, endothelial cells more complete, no obvious damage, partial destruction of smooth muscle cells, darker nuclei, increased intracellular lipid. Fibroblasts and smooth muscle cells showed no obvious proliferation. Electron microscopy in the control group can be seen fibroblasts metabolic activity?