新型生物可降解单面刻槽载药靶向支架对冠状动脉内膜增生的影响  

A novel single-sided groove target release biodegradable stent inhibits coronary artery intimal hyperplasia

作　　者：金慧[1] 李猛[1] 

机构地区：[1]包头市中心医院心内科,内蒙古自治区包头市014040

出　　处：《中国组织工程研究》2017年第26期4222-4227,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:理论上,新型生物可降解单面刻槽载药靶向支架可避免长期存在药物涂层对局部血管壁的致炎作用,减少药物剂量,减少血栓形成的可能性,减轻管腔狭窄。目的:评价生物可降解新型单面刻槽载药支架对健康小型猪冠状动脉内膜增生的影响。方法:将18只健康小型猪随机分为裸支架组、Firebird 2支架组和Firehawk支架组,分别植入L605钴铬合金裸金属支架、L605钴铬合金不可降解涂层雷帕霉素支架和L605钴铬合金可降解单面刻槽涂层雷帕霉素靶向洗脱支架,于左前降支和右冠状动脉各植入相同支架1枚。支架植入后1,3个月时复查冠状动脉造影并处死取材,观察内膜增生情况。结果与结论:(1)冠状动脉造影结果:植入1,3个月时,3组支架段冠状动脉均无狭窄发生,支架段血管均通畅,见血栓及动脉瘤等影像学表现;植入后1,3个月时,Firebird 2支架组、Firehawk支架组管腔丢失均低于裸支架组(P<0.05),Firebird 2支架组与Firehawk支架组管腔丢失比较差异无显著性意义;(2)组织病理学结果:3组均未见支架段冠状动脉管壁组织坏死或管腔内血栓形成;支架植入后1,3个月时,Firebird2支架组、Firehawk支架组新生内膜面积及面积狭窄百分比低于裸支架组(P<0.05),残余管腔面积、内弹力板面积高于裸支架组(P<0.05)。Firebird 2支架组与Firehawk支架组上述各指标比较差异无显著性意义;(3)结果表明:生物可降解新型单面刻槽载药支架可有效抑制冠状动脉内膜增生,预防冠状动脉支架内狭窄,效果与不可降解涂层雷帕霉素支架相当,长期效果仍有待进一步观察。BACKGROUND： Theoretically, a novel single-sided groove target release biodegradable stent can avoid drug-induced inflammation of the local vessel wall, reduce drug dose, decrease the likelihood of thrombosis, and relieve stenosis.OBJECTIVE： To evaluate the influence of the novel single-sided groove target release biodegradable stent on intimal hyperplasia in a healthy porcine coronary artery model.METHODS： Eighteen healthy pigs were randomly divided into three groups, bare metal stent group, Firebird metal stent group and Firehawk stent group, which were implanted with L605 cobalt chromium alloy bare metal stents and L605 cobalt chromium alloy non-biodegradable rapamycin-eluting stent and L605 cobalt chromium alloy biodegradable rapamycin-eluting stent, respectively. Two same stents were implanted into the left anterior descending artery and the right coronary artery of each pig, respectively. After 1 and 3 months of follow-up, coronary angiography was performed,and the pigs were killed to take coronary artery samples for detection of intima hyperplasia.RESULTS AND CONCLUSION： At 1 and 3 months after stent implantation, no stenosis, thrombosis and aneurysm occurred in the three groups shown by the coronary angiography; the lumen loss was significantly lower in the Firebird metal stent group and Firehawk stent group than the bare metal stent group （P 〈 0.05）, while there was no difference between the Firebird metal stent group and Firehawk stent group. Histopatologically, there was no coronary arterial tissue necrosis or luminal thrombosis in the three groups. Compared with the bare metal stent group, at 1 and 3 months after stent implantation, the neointimal area and the percentage of stenosis were significantly lower in the Firebird metal stent group and Firehawk stent group （P 〈 0.05）, while the residual lumen area and internal elastic lamina area were significantly higher （P 〈 0.05）. Additionally, there was no significant difference between the Firebird metal stent group and Firehawk

关 键 词：生物材料 材料相容性 药物洗脱支架 雷帕霉素 聚乳酸 生物可降解 内膜增生 

分 类 号：R318[医药卫生—生物医学工程]