冠心病药物涂层支架置入后再内皮化研究  

Re-endothelialization after placement of drug-eluting stents in patients with CHD

作　　者：罗明华[1] 关怀敏[1] 解金红[1] 陈玉善[1] 王贺[1] 邱承杰[1] 董文杰[1] 宗永华[1] 

机构地区：[1]河南中医学院第一附属医院,郑州市450000

出　　处：《实用医学杂志》2016年第5期724-727,共4页The Journal of Practical Medicine

基　　金：国家自然科学基金(编号:81473507);郑州市科技创新团队基金(编号:121PCXTD520)

摘　　要：目的:探索冠心病患者药物涂层支架(drug-eluting stents,DES)置入1年后冠状动脉再内皮化特点,为术后双联抗血小板时程的制定提供临床参考。方法:入选我院2013年1月至2015年4月入院的冠心病支架置入后1年的患者,进行光学相干断层成像检查的患者纳入本研究,观察支架置入处新生内膜增殖厚度,支架小梁内膜覆盖率等,考察药物涂层支架置入再内皮化的特点。结果:43例患者中的48枚支架,内膜覆盖率90.70%。轻/中/重内膜增殖程度的比例分别为19.92%、37.55%、42.53%。亚组分析,糖尿病组较非糖尿病组以及临床诊断为ACS者较稳定型心绞痛者内膜覆盖率更高,增生程度重。结论:DES置入1年后,绝大多数支架梁被内膜覆盖,但仍存在内皮化不全现象;糖尿病与急性冠脉综合征可能是影响内皮化进程的因素。Objective To investigate the characteristics of coronary vessel re-endothelialization after placement of drug-eluting stents （DES）, and to provide clinical evidence for the double anti-platelet treatment. Methods Optical coherence tomography （OCT） was performed in 43 patients in 1 year after DES implantation. Characteristics of re-endothelialization and percentage of neointimal coverage of stent struts were evaluated by OCT. Results The rate of stent struts intimal coverage was 90.70%, and the remain was lack of endothelial coverage; The ratio of neointimal thickness （NIT） between 0-99, 100-199 and above 200 microns was 19.92%, 37.55% and 42.53%, respectively. The rate of neointimal coverage was higher and the degree of neointimal hy- perplasia was more extensive in patients with DM and in patients with ACS than those of patients without DM and of patients with stable angina pectoris. Conclusion One year after stent placement, most of the stent struts were covered with neointima and few struts obtained poor coverage of endothelial. DM and ACS may be impact factors for the progress of re-endothelialization after DES placement.

关 键 词：冠心病 药物涂层支架 内皮化 光学相干断层成像 糖尿病 急性冠脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]