二烯丙基三硫化物包被支架预防冠状动脉内膜损伤后再狭窄的实验研究  

The study of diallyl trisulfide coating stent in inhibiting neointimal hyperplasia in the canine model of coronary restenosis

作　　者：徐尚华[1] 江洪[1] 李庚山[1] 吴可贵[2] 蒋学俊[1] 李晓艳[1] 陈元秀[1] 王海蓉[1] 

机构地区：[1]武汉大学人民医院心内科 [2]福建医科大学附属第一医院心内科

出　　处：《中华心血管病杂志》2004年第8期747-750,共4页Chinese Journal of Cardiology

基　　金：湖北省九五攻关项目(No.962p1101)

摘　　要：目的 探讨不同剂量二烯丙基三硫化物(diallyl trisulfide,DT)包被支架对犬冠状动脉支架置入术后再狭窄的预防作用。方法 制作蛋白涂层的DT包被支架,其剂量分别为0 μg(对照组)、60 μg(小剂量组)、130μg(中剂量组)和210μg(大剂量组)。11只杂种犬,其左冠状动脉分别置入过大的单纯蛋白包被支架和DT包被支架。术前、术后即刻及术后6个月冠状动脉造影观察动脉狭窄程度;术后6个月取出血管组织,经Elastic-van Gieson染色,进行形态学观察,通过图像分析系统分析测定管腔面积、内弹力板包绕面积,并计算内膜面积和面积狭窄率。结果 各组平均损伤积分相似。大剂量组平均内膜厚度[(0.18±0.03)mm]小于中剂量组[(0.24±0.03)mm,P=0.008]、小剂量组[(0.46±0.05)mm,P<0.001]和对照组[(0.49±0.06)mm,P<0.001];大、中剂量组内膜面积相似[(2.50±0.49)mm2比(2.78±0.78)mm2,P>0.05],但显著小于小剂量组[(4.65±0.58)mm2,P<0.001]和对照组[(4.87±0.80)mm2,P<0.001]。大、中剂量组的面积狭窄率相似[(30.04±5.43)％比(34.25±7.41)％,P>0.05],但显著小于小剂量组[(53.10±1.93)％,P<0.001]和对照组[(54.62±6.82)％,P<0.001]。结论 DT包被支架呈剂量依赖性抑制新生内膜增生,6个月内预防再狭窄疗效明显。Objective To assess the effect of diallyl trisulfide (DT)-coated coronary stents on neointimal proliferation in a canine model of coronary restenosis. Methods DT-coated stents (0,60,130, or 210μg/stent) were deployed with mild oversizing in both the left circumflex coronary arteriy (LCX) and the left anterior descending coronary artery (LAD) of 11 dogs. The treatment effect was assessed 6 months after stents implantation. Results The mean injury scores were similar in all groups. The mean neointimal hyperplasia was (0. 18 ±0. 03) mm for the 210 μg group compared with 130μg group [ (0. 24 ±0. 03) mm, P=0.008] , 60 μg [(0.46±0. 05)mm, P<0.001] or control group [(0.49 ±0.06)mm, P<0.001]. The neointimal area was similar in 210 μg and immediate-dose group [ (2. 50 ±0. 49) mm2, and (2. 78 ± 0. 78) mm2 , respectively P > 0. 05 ] , but was less than that in 60μg group [ (4. 65 ± 0. 58 ) mm2, P < 0. 001 ] or control group [ (4. 87 ± 0. 80 ) mm2, P < 0. 001 ]. The percent area stenosis was similar in 210 μg and 130 μg group [ (30. 04 ± 5. 43) % and (34. 25 ± 7. 41) % , respectively P > 0. 05 ] , but was less than that in 60μg group [ (53. 10 ± 1. 93) mm2, P < 0. 001 ] or control group [ (54. 62 ± 6. 82 ) % , P < 0. 001 ]. There were no cases of aneurysm or thrombosis. Conclusion DT-coated coronary stents produced a significant dose-dependent inhibition of neointimal hyperplasia in the canine LCX and LAD 6 months after stents implantation.

关 键 词：中剂量 对照组 小剂量 支架 再狭窄 内膜 包被 蛋白 形态学观察 图像分析系统 

分 类 号：R543[医药卫生—心血管疾病] R654[医药卫生—内科学]