血管内支架植入后的内皮损伤及其修复策略  

Endothelial injury and its repair strategies after intravascular stents implantation

作　　者：席亚东 黄玉华 杜若林 王亚洲[1] 王贵学[1] 尹铁英[1] Xl Yadong;HUANG Yuhua;DU Ruolin;WANG Yazhou;WANG Guixue;YIN Tieying(Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory For Vascular Implants, Bioengineering College, Chongqing University, Chongqing 400044, P.R.Chin)

机构地区：[1]重庆大学生物工程学院血管植入物开发国家地方联合工程实验室生物流变科学与技术教育部重点实验室,重庆400044

出　　处：《生物医学工程学杂志》2018年第2期307-313,共7页Journal of Biomedical Engineering

基　　金：国家自然科学基金重点项目(11332003);国家重点研发计划项目(2016YFC1102305),重庆市科委领军人才项目(cstc2013kjrc-ljrccj10003);中央高校基本科研业务费资助项目(2015CDJZR);重庆大学“生物流变科学与技术”教育部重点实验室访问学者基金(CQKLBST-2016-003)

摘　　要：动脉粥样硬化性心脏病是严重危害人类生命健康的心血管疾病。近年来其主要的治疗手段是将血管内支架植入到病变部位,支撑血管并重建血运。然而,大量研究表明,血管内支架植入的介入操作、抗增殖药物释放均会对血管内皮造成极大的损伤,大大增加了支架内再狭窄和晚期血栓形成的风险。维持血管内皮的完整和正常功能可明显降低支架植入带来的一系列风险。研究表明,干细胞动员、归巢、分化、增殖是血管内支架植入后血管内皮修复的主要机制,多种血管内因子、力学微环境变化等均参与此过程,进而影响植入部位的再内皮化。本文对支架植入造成血管内皮损伤的过程、损伤后的修复机制及其影响因素等进行详细阐述,并分析总结其修复策略,为深入理解支架内再狭窄、血管内皮化延迟和晚期血栓形成的机制以及新型药物洗脱支架和生物可降解支架的设计提供参考。Coronary atherosclerotic heart disease is a serious threat to human life and health. In recent years, the main treatment for it is to implant the intravascular stent into the lesion to support blood vessels and reconstruct blood supply. However, a large number of experimental results showed that mechanical injury and anti-proliferative drugs caused great damage after stent implantation, and increased in-stent restenosis and late thrombosis risk. Thus, maintaining the integrity and normal function of the endothelium can significantly reduce the rate of thrombosis and restenosis. Stem cell mobilization, homing, differentiation and proliferation are the main mechanisms of endothelial repair after vascular stent implantation. Vascular factor and mechanical microenvironmental changes in implanted sites have a certain effect on re-endothelialization. In this paper, the process of injury caused by stent implantation, the repair mechanism after injury and its influencing factors are expounded in detail. And repairing strategies are analyzed and summarized. This review provides a reference for overcoming the in-stent restenosis, endothelialization delay and late thrombosis during the interventional treatment, as well as for designing drug-eluting and biodegradation stents.

关 键 词：血管内支架 血管内皮细胞 再狭窄 损伤 修复 

分 类 号：R318.1[医药卫生—生物医学工程] R541[医药卫生—基础医学]