劉坤 1 , 楊琨 2 , 羅軍 1 , 王洋 1 , 李新喜 1 , 白超 1 , 揭月高 1
  • 1.新疆醫(yī)科大學(xué)第一附屬醫(yī)院消化血管外科中心(烏魯木齊 830054);;
  • 2.新疆醫(yī)科大學(xué)第一附屬醫(yī)院燒傷整形科(烏魯木齊 830054);

目的 探討結(jié)扎腹主動(dòng)脈加雙側(cè)腹壁陰部動(dòng)脈在SD大鼠后肢動(dòng)脈缺血模型中的應(yīng)用價(jià)值。
方法 將38只大鼠按隨機(jī)數(shù)字表法隨機(jī)分為假手術(shù)組(n=12)、結(jié)扎腹主動(dòng)脈組(n=12)和結(jié)扎腹主動(dòng)脈加雙側(cè)腹壁陰部動(dòng)脈組(n=14)。氯胺酮6 mg/100 g腹腔注射麻醉大鼠，開腹后按各組不同的處理方法處理血管，觀察術(shù)后2周和4周時(shí)各組后肢肌力、蒼白等情況，同時(shí)取股靜脈血做血?dú)夥治觯⑷『笾趋兰⌒蠬E染色。
結(jié)果 結(jié)扎腹主動(dòng)脈加雙側(cè)腹壁陰部動(dòng)脈組術(shù)后3 d內(nèi)死亡2只大鼠，其余大鼠均存活。假手術(shù)組術(shù)后無明顯異常。結(jié)扎腹主動(dòng)脈組術(shù)后立即出現(xiàn)后肢蒼白、活動(dòng)差; 2周時(shí)后肢蒼白、皮溫低有好轉(zhuǎn); 4周時(shí)恢復(fù)正常。結(jié)扎腹主動(dòng)脈加雙側(cè)腹壁陰部動(dòng)脈組術(shù)后2周時(shí)后肢缺血明顯，肢體蒼白、運(yùn)動(dòng)差; 4周時(shí)仍有較明顯的肌力異常、蒼白等表現(xiàn)。各組均無后肢壞死。結(jié)扎腹主動(dòng)脈加雙側(cè)腹壁陰部動(dòng)脈組在術(shù)后2和4周時(shí)的肌力和蒼白情況均較假手術(shù)組差(P lt;0.05); 與結(jié)扎腹主動(dòng)脈組比較,在術(shù)后4周時(shí)肢體蒼白情況仍較差(P lt;0.05)。各組內(nèi)不同時(shí)相間比較,差異均無統(tǒng)計(jì)學(xué)意義(P gt;0.05)。結(jié)扎腹主動(dòng)脈加雙側(cè)腹壁陰部動(dòng)脈組的靜脈血氧分壓在術(shù)后2及4周時(shí)明顯低于其他2組(P lt;0.05)。HE染色： 對照組顯示正常的橫紋肌結(jié)構(gòu)； 結(jié)扎腹主動(dòng)脈組術(shù)后2周可見細(xì)胞染色不均，腫脹，橫紋消失，部分細(xì)胞核染色深，4周時(shí)恢復(fù)正常； 結(jié)扎腹主動(dòng)脈加雙側(cè)腹壁陰部動(dòng)脈組術(shù)后2周及4周見骨骼肌染色不均，細(xì)胞腫脹明顯，橫紋消失，部分細(xì)胞核染色深，密集，細(xì)胞間隙加大，但未見明顯的細(xì)胞壞死。
結(jié)論 結(jié)扎腹主動(dòng)脈加雙側(cè)腹壁陰部動(dòng)脈可制作穩(wěn)定的SD大鼠后肢缺血模型。

引用本文： 劉坤,楊琨,羅軍,王洋,李新喜,白超,揭月高. 結(jié)扎腹主動(dòng)脈加雙側(cè)腹壁陰部動(dòng)脈在大鼠后肢缺血模型中的應(yīng)用. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(3): 258-262. doi: 復(fù)制

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1. Isner JM, Walsh K, Symes J, et al. Arterial gene transfer for therapeutic angiogenesis in patients with peripheral artery disease [J]. Hum Gene Ther, 1996; 7(8): 959988.
2. Tatsumi T, Matsubara H. Therapeutic angiogenesis for peripheral arterial disease and ischemic heart disease by autologous bone marrow cells implantation [J]. Nippon Rinsho, 2006; 64(11): 21262134.
3. Sumi M, Sata M, Toya N, et al. Transplantation of adipose stromal cells, but not mature adipocytes, augments ischemiainduced angiogenesis [J]. Life Sci, 2007; 80(6): 559565.
4. Hamano K, Li TS, Kobayashi T, et al. The induction of angiogenesis by the implantation of autologous bone marrow cells: a novel and simple therapeutic method [J]. Surgery, 2001; 130(1): 4454.
5. Ikenaga S, Hamano K, Nishida M, et al. Autologous bone marrow implantation induced angiogenesis and improved deteriorated exercise capacity in a rat ischemic hindlimb model [J]. J Surg Res, 2001; 96(2): 277283.
6. Kawamoto A, Asahara T, Losordo DW. Transplantation of endothelial progenitor cells for therapeutic neovascularization [J]. Cardiovasc Radiat Med, 2002; 3(34): 221225.
7. Iba O, Matsubara H, Nozawa Y, et al. Angiogenesis by implantation of peripheral blood mononuclear cells and platelets into ischemic limbs [J]. Circulation, 2002; 106(15): 20192025.
8. Iwaguro H, Yamaguchi J, Kalka C, et al. Endothelial progenitor cell vascular endothelial growth factor gene transfer for vascular regeneration [J]. Circulation, 2002; 105(6): 732738.
9. Padilla L, Krtzsch E, Schalch P, et al. Administration of bone marrow cells into surgically induced fibrocollagenous tunnels induces angiogenesis in ischemic rat hindlimb model [J]. Microsurgery, 2003; 23(6): 568574.
10. 劉文亮, 尹邦良, 喻風(fēng)雷, 等. 骨髓單個(gè)核細(xì)胞缺血組織局部移植對血運(yùn)重建的影響 [J]. 中南大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2004; 29(5): 572576.
11. Hiasa K, Ishibashi M, Ohtani K, et al. Gene transfer of stromal cellderived factor1α enhances ischemic vasculogenesis and angiogenesis via vascular endothelial growth factor/endothelial nitric oxide synthaserelated pathway: nextgeneration chemokine therapy for therapeutic neovascularization [J]. Circulation, 2004; 109(20): 24542461.
12. Sato Y, Matsui K, Ajiki T, et al. Can a bone marrow cell contribute to organ regeneration? In vivo analysis using transgenic rats with reporter genes [J]. Transplant Proc, 2005; 37(1): 273275.
13. Otsuka H, Akashi H, Murohara T, et al. The prostacyclin analog beraprost sodium augments the efficacy of therapeutic angiogenesis induced by autologous bone marrow cells [J]. Ann Vasc Surg, 2006; 20(5): 646652.
14. de Nigris F, Balestrieri ML, WilliamsIgnarro S, et al. Therapeutic effects of autologous bone marrow cells and metabolic intervention in the ischemic hindlimb of spontaneously hypertensive rats involve reduced cell senescence and CXCR4/Akt/eNOS pathways [J]. J Cardiovasc Pharmacol, 2007; 50(4): 424433.
15. Qin SL, Li TS, Kubo M, et al. Transient increase of cytokines in the acute ischemic tissue is beneficial to cellbased therapeutic angiogenesis [J]. Circ J, 2008; 72(12): 20752080.
16. Wragg A, Mellad JA, Beltran LE, et al. VEGFR1/CXCR4positive progenitor cells modulate local inflammation and augment tissue perfusion by a SDF1dependent mechanism [J]. J Mol Med, 2008; 86(11): 12211232.
17. Iohara K, Zheng L, Wake H, et al. A novel stem cell source for vasculogenesis in ischemia: subfraction of side population cells from dental pulp [J]. Stem Cells, 2008; 26(9): 24082418.
18. Tajima H, IwaiTakano M, Yaoita H, et al. Mast cells contribute to flow restoration by bone marrow cell transplantation in rats with ischemic limbs [J]. Int Heart J, 2009; 50(2): 247257.
19. 汪忠鎬, 李震. 我國血管外科的現(xiàn)狀和發(fā)展 [J]. 中國普外基礎(chǔ)與臨床雜志, 2006; 13(6): 625628.
20. 梁翠宏. Wistar大鼠后肢缺血模型的實(shí)驗(yàn)研究 [D]. 山東大學(xué), 2005: 17.
21. 劉萬里, 薛茜, 曹明芹， 等. 用 SPSS實(shí)現(xiàn)完全隨機(jī)設(shè)計(jì)多組比較秩和檢驗(yàn)的多重比較 [J]. 地方病通報(bào), 2007; 22(2): 2729.
22. 崔世軍， 俞恒錫， 滕旭， 等. 家兔后肢缺血模型的制作 [J]. 中國比較醫(yī)學(xué)雜志, 2003; 13(1): 3638.
23. Heil M, Ziegelhoeffer T, Pipp F, et al. Blood monocyte concentration is critical for enhancement of collateral artery growth [J]. Am J Physiol Heart Circ Physiol, 2002; 283(6): H2411H2419.
24. 霍鑫， 馮金煒， 劉方峰， 等. pEGFPC1/Akt體外轉(zhuǎn)染骨髓間充質(zhì)干細(xì)胞對后肢缺血大鼠血管生成的影響 [J]. 中國普外基礎(chǔ)與臨床雜志, 2008; 15(6): 402407.
25. Iwatsuki Y, Sakata C, Kawasaki T, et al. Experimental model of lower limb ischemia in rats and the effect of YM466, an oral direct factor Xa inhibitor [J]. Biol Pharm Bull, 2007; 30(10): 18741877.
26. 梁翠宏， 田鏵， 徐蘊(yùn)， 等. 結(jié)扎切斷法與白芨微粒栓塞法建立大鼠后肢缺血模型效果比較 [J]. 山東大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2007; 45(10): 10081010.
27. Pu LQ, Jackson S, Lachapelle KJ, et al. A persistent hindlimb ischemia model in the rabbit [J]. J Invest Surg, 1994; 7(1): 4960.
28. 梁翠宏， 田鏵， 徐蘊(yùn)， 等. 結(jié)扎切斷法制作大鼠后肢缺血模型的效果 [J]. 解剖學(xué)雜志, 2006; 29(6): 795797.
29. 楊安峰, 王平. 大鼠的解剖和組織 [M]. 北京: 科學(xué)出版社, 1980: 124130.
  1. 1. Isner JM, Walsh K, Symes J, et al. Arterial gene transfer for therapeutic angiogenesis in patients with peripheral artery disease [J]. Hum Gene Ther, 1996; 7(8): 959988.
  2. 2. Tatsumi T, Matsubara H. Therapeutic angiogenesis for peripheral arterial disease and ischemic heart disease by autologous bone marrow cells implantation [J]. Nippon Rinsho, 2006; 64(11): 21262134.
  3. 3. Sumi M, Sata M, Toya N, et al. Transplantation of adipose stromal cells, but not mature adipocytes, augments ischemiainduced angiogenesis [J]. Life Sci, 2007; 80(6): 559565.
  4. 4. Hamano K, Li TS, Kobayashi T, et al. The induction of angiogenesis by the implantation of autologous bone marrow cells: a novel and simple therapeutic method [J]. Surgery, 2001; 130(1): 4454.
  5. 5. Ikenaga S, Hamano K, Nishida M, et al. Autologous bone marrow implantation induced angiogenesis and improved deteriorated exercise capacity in a rat ischemic hindlimb model [J]. J Surg Res, 2001; 96(2): 277283.
  6. 6. Kawamoto A, Asahara T, Losordo DW. Transplantation of endothelial progenitor cells for therapeutic neovascularization [J]. Cardiovasc Radiat Med, 2002; 3(34): 221225.
  7. 7. Iba O, Matsubara H, Nozawa Y, et al. Angiogenesis by implantation of peripheral blood mononuclear cells and platelets into ischemic limbs [J]. Circulation, 2002; 106(15): 20192025.
  8. 8. Iwaguro H, Yamaguchi J, Kalka C, et al. Endothelial progenitor cell vascular endothelial growth factor gene transfer for vascular regeneration [J]. Circulation, 2002; 105(6): 732738.
  9. 9. Padilla L, Krtzsch E, Schalch P, et al. Administration of bone marrow cells into surgically induced fibrocollagenous tunnels induces angiogenesis in ischemic rat hindlimb model [J]. Microsurgery, 2003; 23(6): 568574.
  10. 10. 劉文亮, 尹邦良, 喻風(fēng)雷, 等. 骨髓單個(gè)核細(xì)胞缺血組織局部移植對血運(yùn)重建的影響 [J]. 中南大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2004; 29(5): 572576.
  11. 11. Hiasa K, Ishibashi M, Ohtani K, et al. Gene transfer of stromal cellderived factor1α enhances ischemic vasculogenesis and angiogenesis via vascular endothelial growth factor/endothelial nitric oxide synthaserelated pathway: nextgeneration chemokine therapy for therapeutic neovascularization [J]. Circulation, 2004; 109(20): 24542461.
  12. 12. Sato Y, Matsui K, Ajiki T, et al. Can a bone marrow cell contribute to organ regeneration? In vivo analysis using transgenic rats with reporter genes [J]. Transplant Proc, 2005; 37(1): 273275.
  13. 13. Otsuka H, Akashi H, Murohara T, et al. The prostacyclin analog beraprost sodium augments the efficacy of therapeutic angiogenesis induced by autologous bone marrow cells [J]. Ann Vasc Surg, 2006; 20(5): 646652.
  14. 14. de Nigris F, Balestrieri ML, WilliamsIgnarro S, et al. Therapeutic effects of autologous bone marrow cells and metabolic intervention in the ischemic hindlimb of spontaneously hypertensive rats involve reduced cell senescence and CXCR4/Akt/eNOS pathways [J]. J Cardiovasc Pharmacol, 2007; 50(4): 424433.
  15. 15. Qin SL, Li TS, Kubo M, et al. Transient increase of cytokines in the acute ischemic tissue is beneficial to cellbased therapeutic angiogenesis [J]. Circ J, 2008; 72(12): 20752080.
  16. 16. Wragg A, Mellad JA, Beltran LE, et al. VEGFR1/CXCR4positive progenitor cells modulate local inflammation and augment tissue perfusion by a SDF1dependent mechanism [J]. J Mol Med, 2008; 86(11): 12211232.
  17. 17. Iohara K, Zheng L, Wake H, et al. A novel stem cell source for vasculogenesis in ischemia: subfraction of side population cells from dental pulp [J]. Stem Cells, 2008; 26(9): 24082418.
  18. 18. Tajima H, IwaiTakano M, Yaoita H, et al. Mast cells contribute to flow restoration by bone marrow cell transplantation in rats with ischemic limbs [J]. Int Heart J, 2009; 50(2): 247257.
  19. 19. 汪忠鎬, 李震. 我國血管外科的現(xiàn)狀和發(fā)展 [J]. 中國普外基礎(chǔ)與臨床雜志, 2006; 13(6): 625628.
  20. 20. 梁翠宏. Wistar大鼠后肢缺血模型的實(shí)驗(yàn)研究 [D]. 山東大學(xué), 2005: 17.
  21. 21. 劉萬里, 薛茜, 曹明芹， 等. 用 SPSS實(shí)現(xiàn)完全隨機(jī)設(shè)計(jì)多組比較秩和檢驗(yàn)的多重比較 [J]. 地方病通報(bào), 2007; 22(2): 2729.
  22. 22. 崔世軍， 俞恒錫， 滕旭， 等. 家兔后肢缺血模型的制作 [J]. 中國比較醫(yī)學(xué)雜志, 2003; 13(1): 3638.
  23. 23. Heil M, Ziegelhoeffer T, Pipp F, et al. Blood monocyte concentration is critical for enhancement of collateral artery growth [J]. Am J Physiol Heart Circ Physiol, 2002; 283(6): H2411H2419.
  24. 24. 霍鑫， 馮金煒， 劉方峰， 等. pEGFPC1/Akt體外轉(zhuǎn)染骨髓間充質(zhì)干細(xì)胞對后肢缺血大鼠血管生成的影響 [J]. 中國普外基礎(chǔ)與臨床雜志, 2008; 15(6): 402407.
  25. 25. Iwatsuki Y, Sakata C, Kawasaki T, et al. Experimental model of lower limb ischemia in rats and the effect of YM466, an oral direct factor Xa inhibitor [J]. Biol Pharm Bull, 2007; 30(10): 18741877.
  26. 26. 梁翠宏， 田鏵， 徐蘊(yùn)， 等. 結(jié)扎切斷法與白芨微粒栓塞法建立大鼠后肢缺血模型效果比較 [J]. 山東大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2007; 45(10): 10081010.
  27. 27. Pu LQ, Jackson S, Lachapelle KJ, et al. A persistent hindlimb ischemia model in the rabbit [J]. J Invest Surg, 1994; 7(1): 4960.
  28. 28. 梁翠宏， 田鏵， 徐蘊(yùn)， 等. 結(jié)扎切斷法制作大鼠后肢缺血模型的效果 [J]. 解剖學(xué)雜志, 2006; 29(6): 795797.
  29. 29. 楊安峰, 王平. 大鼠的解剖和組織 [M]. 北京: 科學(xué)出版社, 1980: 124130.