雷帕霉素-巴曲酶复合药物涂层支架预防支架内再狭窄的实验研究  

Experimental study on rapamycin-batroxobin eluting stent and its prevention of coronary restenosis after angiophaty

作　　者：陈丹[1] 吕安林[1] 张薇[1] 苑媛[1] 刁繁荣[1] 李军杰[1] 

机构地区：[1]第四军医大学西京医院心血管内科,陕西西安710032

出　　处：《心脏杂志》2007年第2期185-188,共4页Chinese Heart Journal

摘　　要：目的评价雷帕霉素-巴曲酶复合药物涂层支架对再狭窄和支架内血栓的防治作用及安全性,减少术后抗血小板药物的应用及并发症的发生率。方法采用随机、双盲试验在16头微型猪的冠状动脉前降支或左旋支分别置入支架1枚,其中雷帕霉素涂层支架(每枚支架药物剂量1.2μg/mm2)共8枚,为对照组;雷帕霉素-巴曲酶复合药物涂层支架(每枚支架含雷帕霉素1.2μg/mm2、巴曲酶0.3μg/mm2)共8枚,为实验组。对照组术前3 d起每天口服氯吡格雷75 mg和阿司匹林0.3 g直至28 d处死;实验组术前3 d至术后7 d每天口服氯吡格雷75 mg和阿司匹林0.3 g,此后改为每天口服阿司匹林0.3 g,直至28 d处死。28 d时进行冠状动脉造影随访,术后处死动物,取出支架血管,进行组织学分析。结果再狭窄率:对照组为0,实验组为0。管腔丢失率:对照组为(7±5)%,实验组为(4±3)%。新生内膜面积:对照组为(1.0±0.8)mm2,实验组为(0.9±0.7)mm2。结论雷帕霉素-巴曲酶复合药物涂层支架与单纯雷帕霉素涂层支架比较可以减少支架置入术后的口服氯吡格雷总量及用药时间。AIM To determine the efficacy of stent coated with combined rapamycin （Rapa） and batroxobin （Batr） in reducing the neo-hyperplasia of vascular endothelium, thrombogenesis and the incidence of complications after angiophaty. METHODS Sixteen miniature pigs with a stent implanted in the coronary arteries were divided in 2 groups randomly and double-blindly. Stents were coated with PLGA （ poly/lactic-co-glycolic acid） polymer containing 1.2 μg/mm^2 Rapa （Rapa group） or 1.2 μg/mm^2 Rapa and 0.3μg/mm^2 Batr （Com group）. Clopidogrel 75 mg and aspirin 0.3 g were given from 3 days before operation till 28 days after operation in Rapa group. Clopidogrel and aspirin of the same dosages were also given in Com group from 3 days before operation to 7 days after operation, and then only aspirin 0.3 g was given till the 28th day. On the 28th day, coronary arteriographies were conducted and the pigs were sacrificed. Stents were taken out for histological analysis. RESULTS There was no restenosis in both Corn and Rapa groups. The average stenosis degree was （7 ± 5 ）% in Rapa group and （4 ± 3 ）% in Corn group. Square of the neo-hyperplasia vascular endothelium was （ 1.0 ± 0.8 ）mm^2 in Rapa group and （0.9 ± 0.7）mm^2 in Corn group. CONCLUSION Compared with Rapa-coated stents, the application of Rapa ＋ Batr-coated stents can reduce the dosage and duration of Clopidogrel.

关 键 词：支架 再狭窄 雷帕霉素 巴曲酶 

分 类 号：R541.4[医药卫生—心血管疾病]