雷帕酶素和巴曲酶复合药物涂层支架预防支架内再狭窄的实验研究  

Effects of stent-based rapamycin-batroxobin on neointimal formation in a porcine coronary model

作　　者：宋延彬[1] 吕安林[1] 陈丹[1] 刁繁荣[1] 李军杰[1] 温俊娜[1] 孟晓雪[1] 胡艳[1] 梁炎华[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》2008年第1期61-64,共4页Chinese Heart Journal

摘　　要：目的评价裸支架、巴曲酶支架、雷帕酶素支架、雷帕酶素和巴曲酶复合药物涂层支架(rapamycin-batroxobin eluting stent,RBES)抑制内膜增生的作用以及预防支架内再狭窄的效果。方法采用微喷法制备雷帕酶素和巴曲酶复合药物涂层支架,将裸支架、巴曲酶支架和雷帕酶素支架做为对照,复合药物组减少术后服用氯吡格雷的剂量和时间。于支架置入后3、7、28d截取支架段血管连同邻近的近端正常血管段,通过病理组织学分析和聚合酶链反应技术检测支架局部内膜增生情况。结果复合药物支架、雷帕酶素支架在再狭窄率、冠脉狭窄程度、管腔面积、新生内膜面积方面与裸支架组、巴曲酶支架组有显著差异(P<0.05)。复合药物支架组与雷帕酶素组在再狭窄率、冠脉狭窄程度、管腔面积、新生内膜面积方面无显著差异。裸支架组、巴曲酶支架组在再狭窄率、冠脉狭窄程度、管腔面积、新生内膜面积方面无显著差异。正常血管段在各个时间段增殖细胞核抗原(PCNA)mRNA均呈现无明显差异的低表达。裸支架、巴曲酶支架、雷帕酶素支架和复合药物支架置入后3d局部血管壁PCNA mRNA即呈现高表达,裸支架、巴曲酶支架显著高于正常血管段。雷帕酶素支架和复合药物支架略高于正常血管段,显著低于裸支架、巴曲酶支架,巴曲酶支架略低于裸支架;复合支架略低于雷帕酶素支架。结论复合药物支架置入可在一定程度上抑制内膜的增生反应,预防支架内再狭窄。AIM To determine the efficacy of stent-based rapamycin or batroxobin alone or the combination of both of them in reducing in-stent neointimal hyperplasia. METHODS Models of coronary stent implantation was established in mini-pigs. The clopidogel dose and healing time after precutaneous coronary intervention were decreased in rapamycin-batroxobin eluting stent groups compared with those in naked stent groups, batroxobin eluting stent groups and rapamycin eluting stent groups. The process of noeintima hyperplasia and the level of PCNA mRNA were detected at day 3, 7and 28 by histological method and reverse transcription polymerase chain reaction technique respectively. RESULTS Significant difference was found between rapamycin-batroxobin eluting stent groups and naked stent groups, batroxobin eluting stent groups but no significant difference was found between rapamycin-batroxobin eluting stent groups and rapamycin eluting stent groups. CONCLUSION The implantation of rapamycin-batroxobin eluting stent restrains neointima hyperplasia, reduces restenosis after percutaneous coronary intervention and deceases the clopidogel dose and healing time.

关 键 词：支架 雷帕酶素 巴曲酶 内膜 

分 类 号：R541.4[医药卫生—心血管疾病]