川芎嗪涂层支架抑制冠状动脉内膜增殖的实验研究  

The Experimental Study of Tetramethylpyrazine-Eluting Stents on Preventing In-stent Intima Hyperplasia

作　　者：丁澍[1] 马根山[2] 严金川[1] 冯毅[2] 沈成兴[2] 陈忠[2] 

机构地区：[1]江苏大学附属医院心内科,212001 [2]东南大学附属中大医院心内科

出　　处：《天津医药》2008年第5期360-362,共3页Tianjin Medical Journal

基　　金：江苏省社会发展计划项目(项目编号:BS2004026)

摘　　要：目的:观察川芎嗪涂层支架(TES)对猪冠状动脉内膜增殖的影响。方法:纯度为99%的川芎嗪单体、甲基丙烯酸甲酯共聚物和聚乙醇酸均匀喷涂于金属裸支架上,制成含川芎嗪200μg的涂层支架。对猪行冠状动脉造影并在左前降支中段随机植入TES或金属裸支架(BMS)一枚,术后第28天复查造影,并对支架段血管进行组织形态学检查及增殖细胞核抗原(PCNA)分析。结果:10头猪(BMS对照组5只,TES组5只)顺利完成复查。28d定量冠脉造影显示晚期管径丢失TES组与对照组相比明显减小(P<0.01);TES组支架段血管直径狭窄百分比亦明显减小(P<0.05)。组织形态学检查显示2组血管损伤评分和支架内面积相近(P>0.05),但TES组新生内膜面积较对照组明显减少(P<0.01),平均面积狭窄百分比及PCNA指数较对照组降低(P<0.01)。结论:与金属裸支架相比,川芎嗪涂层支架明显抑制支架内新生内膜增殖,降低再狭窄率。Objective： To evaluate the effect of tetramethylpyrazine-eluting stent （TES） on preventing in-stent intima hyperplasia. Methods：The TES was prepared by uniformly sprayed painting the bare metal stents （BMS） with tetramethylpyrazine monomer （200μg）,methyl methacrylate copolymer and polyglycolic acid. Stent overdilation injury was performed with BMS and TES in porcine coronary arteries. Follow-up quantitative coronary angiography （QCA） and histopathologic assessments of stented coronary arteries were performed 4 weeks after stenting, aosults： The TES （n=5） and control ofBMS （n=5） were implanted respectively in ten porcines which survived and QCA re-examination were completed 28 day later. QCA showed the late lumen loss[（0.28 ± 0.08 ）ram vs（ 1.70 ± 0.52 ）ram, P = 0.004] and percentage of diameter stenosis[（ 10.0 ± 2.1 ）% vs（60.2 ± 23.5 ）% ,P = 0.01] were significantly lower in the TES group than those of control. Histopathologic assessments of stented coronary arteries showed that the injury score and the in-stent area were similar between the groups（P 〉 0.05） while the lumen area was significantly larger [（4.34 ± 0.93）mm^2 vs（ 1.29 ± 1.02）mm^2,P = 0.011] in the TES group than that in the control group. The proliferating cell nuclear antigen-positive cells were significantly decreased in the TES group compared to those of control group[（ 14.7 ± 2.5 ）% vs （23.6 ± 3.2 ）%, P = 0.008]. Conclusion： Compared with BMS,TES inhibited the neointimal hyperplasia and reduced in-stent restenosis in porcine coronary artery restenosis models.

关 键 词：川芎嗪 支架 冠状血管造影术 冠状动脉再狭窄 模型 动物 

分 类 号：R541.4[医药卫生—心血管疾病] R87[医药卫生—内科学]