冠状动脉内支架生物相容性及临床应用  

Biocompatibility and clinical application of coronary stents

作　　者：胡雅光[1] 张会久[1] 杨英杰[1] 

机构地区：[1]辽宁医学院附属第三医院心内科,辽宁省锦州市121001

出　　处：《中国组织工程研究与临床康复》2008年第17期3297-3300,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：金属血管支架因其形态稳定性限制了血管的回缩,从而防止了不利的血管重构,但金属内支架本身具致凝性,置入血管后需长期抗凝治疗,作为异物置入后刺激血管内平滑肌细胞增生,不能完全预防再狭窄的发生,通过对金属支架表面修饰可以减少血栓形成。药物涂层支架以金属支架为载体携带活性药物到达血管损伤局部,使药物在较长时间内充分释放到血管壁内,减少支架植入后再狭窄的发生,但涂层药物在抑制平滑肌细胞增殖的同时,也抑制正常内皮细胞的再生,导致支架植入后血管内皮化过程延迟,增加了迟发性血栓形成风险。支架置入术的操作技巧、不同的加工工艺及设计对血管的损伤方式和损伤大小不同,从而能够影响植入后再狭窄的发生。开发新的涂层材料、涂层药物、改进剂型、改善支架结构将是介入治疗领域研究的重点。Resulting from the shape stability, metal vascular stent has limited the vascular retraction, and subsequently prevent the unfavorable vascular remodeling. However, the metal stent requires further anticoagulant therapy after implantation, induces the hyperplasy of vascular smooth muscle cells, and cannot completely prevent the occurrence of in-stent restenosis. Surface modification of metal stent may reduce thrombogenesis. Based on the metal stent, drug eluting stent can transfer the active drugs to the damaged vessels, release them into the vascular wall and inhibit the in-stent restenosis. The eluting drugs restrain both the proliferation of smooth muscle cells and the regeneration of normal endothelial cells, leading to delay the vascular endothelialization and increase the risk of delayed thrombogenesis. The effect of stent implantation on the modus and size of vascular injury varies according to different operational techniques, processing technologies and designs, thus influencing the occurrence of in-stent restenosis. It is a potential study topic of interventional therapy to develop new eluting materials and eluting drugs, modify formulation, as well as facilitate the stent structure.

关 键 词：冠状动脉内支架 金属支架 药物涂层支架 加工工艺 血栓形成 再狭窄 

分 类 号：R318[医药卫生—生物医学工程]