冠脉分叉病变及支架后再狭窄的血流动力学研究进展  

Hemodynamic Research Progress of Coronary Bifurcation Lesions and In-Stent Restenosis

作　　者：刘修健[1] 蔺嫦燕[1] 

机构地区：[1]首都医科大学附属北京安贞医院北京市心肺血管疾病研究所,北京100029

出　　处：《中国生物医学工程学报》2012年第3期446-450,共5页Chinese Journal of Biomedical Engineering

基　　金：北京市自然科学基金(3112011)

摘　　要：全球每年约有100万例经皮冠脉介入(PCI)治疗患者,其中分叉病变约占20%,而其支架后再狭窄率高达30%。频繁的再狭窄不仅和支架与血管的变形、支架与血管顺应性不匹配有关,也和支架后局部血流动力学变化引起的内膜增生有关。文中回顾了分叉冠脉的血流动力学研究发展,分析了分叉病变的血流动力学因素研究现状,详细阐述了其支架后再狭窄相关的计算流体力学(CFD)研究进展。CFD研究为探讨分叉冠脉的血流动力学环境与斑块形成、支架植入术与支架后再狭窄之间的关系提供了很好的技术手段,对临床医生理解斑块形成、工程师改善支架结构设计技术起到一定的作用。Approximately one million patients worldwide undergo percutaneous coronary intervention（PCI） each year.Treatment of coronary bifurcation lesions is involved in about 20% of the total number of PCI,and in-stent restenosis rate occurs in 30% of the cases following the procedures.Recent investigation results have shown that frequent restenosis is related not only to stent structural deformation or compliance mismatch,but also to the intimal hyperplasia induced by local hemodynamic changes.This paper reviews the coronary bifurcation’s hemodynamic study history,analyzes the hemodynamic factors in bifurcation lesions,and the recent literature regarding computational fluid dynamics（CFD） analyses of blood flow through implanted coronary stents.CFD study provides a good technical means for understanding the relationship among the hemodynamic environment and plaque formation,stent implantation and restenosis.Ultimately,this information may be useful for clinicians to understand plaque formation and engineers to improved bifurcation stent designing techniques.

关 键 词：冠状动脉 支架后再狭窄 血流动力学 粥样硬化 

分 类 号：R318.08[医药卫生—生物医学工程]