冠状动脉支架表面涂层材料对置入效果的影响  

Coronary stent surface coating materials influence the implant effect

作　　者：罗康华[1] 许向东[1] 

机构地区：[1]九江学院临床医学院/附属医院心内科,江西省九江市332000

出　　处：《中国组织工程研究与临床康复》2010年第42期7927-7930,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:阐述冠状动脉内支架的临床应用进展,并探讨冠状动脉支架的表面涂层材料对置入后支架内血栓形成和再狭窄的影响。方法:作者以"冠脉内支架,表面涂层,血栓,再狭窄"为检索词,在中国期刊全文数据库(CNKI:2002/2008)及Medline数据库(PubMed:1974/2006)中,采用电子检索的方式进行文献检索。排除Meta分析及重复性研究,共检索到25篇文献,从冠状动脉内支架置入治疗进展,不同表面涂层材料及其对支架内血栓形成和再狭窄的影响等方面进行探讨。结果:冠状动脉内药物洗脱支架置入是治疗冠心病的常用方法,效果明显,并发症很少。冠状动脉内支架表面涂层材料有雷帕霉素、紫杉醇、肝素、二烯丙基三硫化物、地塞米松以及不可降解的聚合物等,均能促进内皮细胞修复,抑制平滑肌细胞增殖,防治支架内血栓形成和再狭窄,保持支架的通畅。由于残留的涂层材料刺激平滑肌细胞增殖,近年使用的可降解的聚合物涂层能进一步提高支架的通畅率。如肝素化聚氨酯涂层、聚乳酸聚羟基乙酸共聚物雷帕霉素涂层和聚砜-聚氧化乙酸共聚物雷帕霉素涂层具有良好的组织相容性,抑制内膜增生,改善再狭窄,有望成为新的冠状动脉内支架涂层材料。结论:冠状动脉内药物洗脱支架置入和阿司匹林、氯吡格雷联合应用是冠状动脉血运重建的良好方法,随着涂层材料的不断更新,支架的通畅率将得到进一步提高。OBJECTIVE： To describe the clinical application of intracoronary stent, and to explore the surface coating materials of coronary stent for stent thrombosis and restenosis after implantation. METHODS： Using ＂intracoronary stent, surface coating, thrombosis, restenosis＂ in Chinese as the Key words, China Academic Journal Full-text database （CNKI： 2002/2008） and Medline databases （Pubmed： 1974/2006） were retrieved online. Meta analysis and reproducible study were excluded. A total of 25 articles were screened out, discussing the progress of intracoronary stent implantation treatment, different surface coating materials and their influence on the thrombosis and restenosis. RESULTS： Drug-eluting intracoronary stent is a common method of treating coronary heart disease, with remarkable effect and rare complications. Intracoronary stent surface coating materials include rapamycin, paclitaxel, heparin, diallyl sulfide, dexamethasone, and non-degradable polymers, they can promote endothelial cells repair, inhibit smooth muscle cells proliferation, prevent stent thrombosis and restenosis, and maintain stent patency. The residual coating materials stimulate smooth muscle cells to proliferate, biodegradable polymer coating which is used in recent years can improve the patency rate of the stent. Heparinized polyurethane coatings, poly lactic acid glycolic acid copolymer rapamycin coating and polysulfone-polyethylene oxide copolymer coating have good histocompatibility, inhibit intimal hyperplasia and improve the restenosis, they are expected to become a new intracoronary stent coating material. CONCLUSION： Intracoronary drug-eluting stent implantation in combination with aspirin and clopidogrel is a good method for coronary revascularization, with the coating materials continuously update; stent patency rates will be further enhanced.

关 键 词：冠状动脉内支架 表面涂层 血栓 再狭窄 生物材料 

分 类 号：R318[医药卫生—生物医学工程]