Objective To investigate the effects on the early postoperative juxta-anastomotic venous inflammatory response and intimal hyperplasia of arteriovenous fistula (AVF) in rabbits constructed with the no⁃touch technique (NTT) to dissect veins. Methods Twenty-four male rabbits were randomly divided into conventional technique (CT) group and NTT group, with 12 rabbits in each group. AVFs were constructed with CT to dissect the veins in CT group, and with NTT to dissect veins in NTT group. At the 7th day after the operation, the juxta-anastomotic veins of AVFs were randomly collected in 6 rabbits from each group. The mRNA expressions of toll-like receptor 4 (TLR4), nuclear factor⁃κB p65 (NF⁃κB p65), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the juxta-anastomotic veins were measured by quantitative reverse transcription PCR. At the 21st day after the operation, juxta-anastomotic veins of AVFs were collected in the remaining 6 rabbits from each group, the intimal thickness and the ratio of intima-media thickness were measured after hematoxylin-eosin staining, and the expression of proliferating cell nuclear antigen (PCNA) in the intima was detected by immunohistochemistry. Results The intimal thickness and intima-media thickness ratio of juxta-anastomotic veins were 23.7±3.1μm and 26.5±2.3% respectively in the CT group, significantly higher than those of（19.5±2.2）μm and 22.7±1.9% in the NTT group (t=2.726 and 3.145 respectively; P=0.021 and 0.010 respectively). The positive expression rate of PCNA in the intimal cells of juxta-anastomotic veins was 20.2±2.3% in the CT group, significantly higher than that of 15.2±1.8% in the NTT group (t=4.242, P=0.002). The relative mRNA expressions of TLR4, NF⁃κB p65, TNF-α and IL-1β of juxta-anastomotic veins in the CT group were also significantly higher than those in the NTT group (t=13.457, 12.116, 9.693 and 9.678 respectively; P＜0.001). Conclusions Compared with CT, dissection of veins using NTT for the construction AVF in rabbits could attenuate the early postoperative juxta-anastomotic venous inflammatory response and intimal hyperplasia.
ZHANG Chun-Hua
,
JIAO Zi-Zhao
,
AN Chuan-Guo
. Effects on the early postoperative juxta-anastomotic venous inflammatory response and intimal hyperplasia in arteriovenous fistula in rabbits constructed with the no⁃touch technique to dissect the veins[J]. Chinese Journal of Blood Purification, 2023
, 22(09)
: 701
-705
.
DOI: 10.3969/j.issn.1671-4091.2023.09.015
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