Mytrolimus药物洗脱支架预防支架内再狭窄的实验研究  

Experimental study of Mytrolimus-eluting stents on preventing restenosis in porcine coronary model

作　　者：邱洪[1] 高润霖[1] 唐智荣 孟亮[1] 兆恒 阮英卯[1] 赵红[1] 杨跃进[1] 陈纪林[1] 陈在嘉[1] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院冠心病诊疗中心,北京100037 [2]微创医疗器械(上海)有限公司

出　　处：《中华心血管病杂志》2005年第6期561-564,共4页Chinese Journal of Cardiology

摘　　要：目的评价新型聚烯烃类高分子化合物涂层携载雷帕霉素衍生物-Mytrolimus(CCI-779)洗脱支架在小型猪冠状动脉模型预防再狭窄的疗效。方法小型猪冠状动脉分别置入裸支架、单纯聚烯烃类高分子化合物涂层支架和Mytrolimus洗脱支架(160μg/18mm)。术后4周重复冠状动脉造影后处死动物,测定3组支架血管段的损伤指数、冠状动脉横截面积、管腔面积、支架上平均内膜厚度、支架间平均内膜厚度、新生内膜面积、面积再狭窄百分比,并作比较。结果裸支架组(置入支架数n=10)、单纯聚烯烃类高分子化合物涂层支架组(n=10)和Mytrolimus洗脱支架组(n=8)3组冠状动脉大小和血管损伤程度基本相同,术后4周,单纯聚烯烃类高分子化合物涂层组与裸支架比较多项参数差异均无统计学意义。Mytrolimus药物洗脱支架组和裸支架组的支架上内膜厚度分别为(0.18±0.08)mm和(0.33±0.25)mm(P<0.05);支架间内膜厚度分别为(0.14±0.05)mm和(0.28±0.23)mm(P<0.05);新生内膜面积分别为(1.09±0.24)mm2和(2.44±1.59)mm2(P<0.05)。上述多项参数在Mytroliums洗脱支架组均显著少于裸支架组。Mytrolimus组新生内膜面积比裸支架组少了55.33%,且Mytrolimus组无一例再狭窄。结论Mytrolimus洗脱支架在置入小型猪冠状动脉4周时可有效抑制内膜增生、预防冠状动脉实验性支架内再狭窄。Objective To assess the efficacy of Mytrolimus (CCI-779),a derivative of rapamycin, eluting stents in preventing restenosis in the porcine model. Methods The bare stents( n =10), stents coated with polyolefin( n =10) or stents coated with Mytrolimus(160 μg/18 mm) in polyolefin( n =8) were implanted in left anterior descending coronary arteries or right coronary artery of mini-swine. Coronary angiography was performed after 4 weeks then the animals were sacrificed. The cross sections of the stented coronary arteries were analyzed, the injury score, luminal area, neointimal thickness above the struts and between the struts of stents, neointimal area and percentage of restenosis were measured.Results The mean injury scores and luminal area were similar in three groups. There was no difference in above-stated items between the polyolefin coating stent and bare mental stent. To compare Mytrolimus-eluting stent with bare-stent, neointimal thickness above the struts [(0.18±0.08)mm vs (0.33±0.25)mm, P <0.05] and between the struts [(0.14±0.05) mm vs (0.28±0.23) mm, P <0.05] and neointimal area [(1.09±0.24)mm 2 vs (2.44±1.59)mm 2, P <0.05] were significantly decreased in the Mytrolimus-eluting stent group than in bare mental stent group. Compared with bare-stent, the Mytrolimus eluting stent was associated with a 55.33% reduction in neointimal area. No restnosis developed in the Mytrolimus group.Conclusion The Mytrolimus-eluting stents can effectively inhibit the neointimal hyperplasia in stented areas of coronary arteries 4 weeks after stent implantation in porcine model.

关 键 词：Mytrolimus 药物洗脱支架 疾病预防 支架内再狭窄 实验研究 雷帕霉素 冠状动脉 

分 类 号：R543[医药卫生—心血管疾病]