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目的探讨抗血小板药氯吡格雷对兔髂腹动脉球囊损伤后内膜增生的影响和机制。方法37只新西兰兔随机分为正常对照组(7只)、模型组(10只)、氯吡格雷组(10只)和阿托伐他汀组(10只)。检测血脂和高敏C反应蛋白(hs-CRP)。观察动脉病理形态学改变,测量内膜、中膜厚度和面积,原位杂交检测血小板源性生长因子(PDGF)mRNA在髂动脉的表达,免疫组织化学染色测定凋亡蛋白bcl-2和bax的表达。结果与模型组比较,氯吡格雷组血清hs-CRP浓度、内膜/中膜厚度比、内膜/中膜面积比显著减少(P<0.05);髂动脉PDGFmRNA的表达明显降低(P<0.05),bcl-2表达下降不明显,bax表达明显升高,bcl-2/bax比值明显降低(P<0.05),氯吡格雷对血脂无明显影响。结论氯吡格雷减轻兔髂腹动脉球囊损伤后血管内膜增生,机制与降低动脉炎症反应,抑制PDGF表达和促进细胞凋亡有关。
Objective To investigate the effect and mechanism of antiplatelet agent clopidogrel on intimal hyperplasia after balloon injury of il ioarterial artery in rabbits. Methods 37 New Zealand white rabbits were randomly divided into normal control group (n = 7), model group (n = 10), clopidogrel group (n = 10) and atorvastatin group (n = 10) Blood lipids and high-sensitivity C-reactive protein (hs-CRP) were detected. The pathological changes of arteries were observed and the intima and media thickness and area were measured. The expression of platelet derived growth factor (PDGF) mRNA in the iliac artery was detected by in situ hybridization. The expressions of apoptosis proteins bcl-2 and bax were detected by immunohistochemical staining expression. Results Compared with model group, hs-CRP, intima / media thickness ratio and intima / media area ratio in clopidogrel group were significantly decreased (P <0.05); PDGF mRNA expression in iliac artery was significantly decreased (P <0.05 ), the expression of bcl-2 was not significantly decreased, bax expression was significantly increased, bcl-2 / bax ratio was significantly decreased (P <0.05), clopidogrel had no significant effect on blood lipids. Conclusion Clopidogrel can attenuate the intimal hyperplasia after balloon injury of the iliac arteries in rabbits. The mechanisms are related to the reduction of arterial inflammation, the inhibition of PDGF expression and the promotion of apoptosis.