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目的:建立慢性肾功能衰竭(chronic renal failure,CRF)合并颈部动静脉内瘘(arteriovenous fistula,AVF)的新西兰兔模型,研究CRF对AVF静脉内膜增生(venous neointimal hyperplasia,VNH)的影响。方法:32只健康新西兰兔随机等分为肾衰组和健康组,每组16只。肾衰组以腺嘌呤诱导新西兰兔CRF后建立AVF模型,健康组不做CRF诱导建立AVF模型。术后第4周取瘘口静脉段行HE染色评估内膜厚度、面积,免疫组织化学检测增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)的表达评估其增殖活性,取肾组织行HE染色观察病理学改变。结果:肾衰组血尿素氮、肌酐水平于第4周明显增加,第6周时达正常值3倍左右,光镜下可见肾小管萎缩消失、结晶物沉着、间质纤维化伴炎症细胞浸润;肾衰组AVF静脉平均内膜厚度、面积及PCNA表达量均明显高于健康组(P﹤0.05)。结论:腺嘌呤可诱导家兔CRF形成,CRF对VNH具有促进作用,加快AVF的功能障碍,因此在研究AVF早期功能障碍时需建立CRF的AVF模型,以保证研究的科学性。
OBJECTIVE: To establish a New Zealand rabbit model of chronic renal failure (CRF) combined with arteriovenous fistula (AVF) of the neck to investigate the effect of CRF on venous neointimal hyperplasia (VNH). Methods: Thirty-two healthy New Zealand rabbits were divided equally into renal failure group and healthy group, with 16 in each group. AVF model was established in neonatal rabbits with CRF induced by adenine in renal failure group, while the AVF model was established in healthy group without CRF induction. At 4 weeks after operation, the thickness of the intima was evaluated by HE staining, and the proliferative cell nuclear antigen (PCNA) expression was evaluated by immunohistochemical staining. The proliferative activity was evaluated by HE staining. Neo-Confucianism changes. Results: The levels of blood urea nitrogen and creatinine in renal failure group increased significantly at the 4th week, reached about 3 times of the normal value at the 6th week. The renal tubular atrophy disappeared, the crystallized substance was sedated and interstitial fibrosis with inflammatory cell infiltration was observed under the light microscope. The mean intimal thickness, area and PCNA expression of AVF in failing group were significantly higher than those in healthy group (P <0.05). CONCLUSION: Adenine can induce the formation of CRF in rabbits. CRF can promote VNH and accelerate the dysfunction of AVF. Therefore, it is necessary to establish the AVF model of CRF in the early stage of AVF to ensure the scientificity of the study.