血管通防治家兔髂動脈經皮腔內成形術(PTA)後再狹窄的研究

Effect of Xue Guan Tong on Restenosis after Experimental Angioplasty with Rabbit Iliac Atherosclerosis Model

本實驗採用家兔髂動脈粥樣硬化模型，研究傳統中醫活血化瘀名方血府逐瘀湯製成的顆粒劑——血管通對經皮腔內血管成形術(PTA)後再狹窄的影響，的隻紐西葫純種兔用4F．Fogarty 導管剝脫損傷科動脈內皮後，餵高膽固醇混合飼料6 週，略動脈造影顯示形成粥樣硬化狹窄，行PTA 後，隨機分為血管通車且、美降脂(Lovastatin)組、空白對照組，（血管通6 克／公斤／日，其降脂6 毫克／公斤／日），PTA後即日停飼高脂飼料，4 週後重複動脈造影，並行血脂和病理學檢查，結呆顯示：(1)三組備動脈管腔內徑分別是1.82＋0.46 mm 、0.96＋0.71 mm 、0.71 土0.53mm，血管通組明顯大於其他兩組(P<0.0l 和P <0.00l)。血管病變再狹窄率血管通組為27%，美降脂組烏62%，空白對照是且為90.99%，血管通姐和空白對照祖相比明顯降低(P<0.005)；(2)三組皓動脈內膜厚度分別是0.27＋0.04mm、0.43＋0.04 mm、0.48 士0.10 mm，血管通組明顯小於其他兩組(P < 0.00l)；(3)透射電鏡觀察，血管通組SMC內細胞器少，含有肌絲，分化較好；空白對照組、其降脂組細胞內細胞器多，處於增殖狀態；(4)三組PTA 後4週血脂水平沒有顯著差異。由此說明：血管通對防治家兔髂動脈粥樣硬化PTA後再狹窄有一定的作用。

This experiment was designed to study the effect of ”Xue Eu Zhu Yu Tang” made in the form of granule which is a Chinese traditional medicine recipe of promoting blood circulation and removing stasis on the restenosis after percutanous transluminal angioplasty (PTA) with iliac atherosclerotic model of purebred New Zealand rabbit. Denude endothelium of iliac of artery by 4F Fogarty balloon catheter and fed them with 2% cholesterol mix supplement for six weeks, and then, segmented atherosclerotic stenosis was formed. After PTA the rabbit was randomly divided into three groups: ”Xue Guan Tong” group, lovastatin group and control group. Stopping cholesterol supplement after PTA, four weeks after PTA, operated examination of blood TC, TG, artery angiograph and pathological finding showed: (1) The artery luminal diameter was 1.82±0.46 mm in ”Xue Guan Tong” group, 0.96 ± 0.71 mm in lovastatin group, 0.71 ± 0.53 mm in control group. The luminal diameter in ”Xue Guan Tong” group was significant larger than that of other two groups (P＜0.01 and P＜0.001). The restenosis rate of the diseased artery was 27% in ”Xue Guan Tong” group, 62% in lovastalin group and 90.09% in control group. There was a highly significant difference of restenosis rate between ”Xue Guan Tong” group and control groups (P＜0.005), (2) Intimal thickness was 0.27 ± 0.40 mm in ”Xue Guan Tong” group, 0.43 ± 0.04 mm in lovastatin group and 0.48 ± 0.10 mm in control group. The thickness in ”Xue Guan Tong” group was thinner than that of other two groups (P＜0.001). (3) There were fewer organelles in ”Xue Guan Tong” group by transmission electron micrograph, SMCs in control group and lovastatin group had more organdies and was in the status of hyperplasia. (4) There was no difference in blood TC and TG among three groups. In conclusion, ”Xue Guan Tong” had preventive effect on restenosis after PTA with rabbit iliac artery atherosclerosis model.