可降解镁支架对移植静脉吻合口再狭窄内膜增生及内皮化的影响  

Effect of Biodegradable magnesium alloy stents in neointima proliferation and re-endothelialization of vein graft anastomotic restenosis

作　　者：李宇罡[1] 杨栋[1] 王磊[1] 吕俊远[1] 于丹[1] 辛世杰[1] Li Yugang;Yang Dong;Wang Lei;Lyu Junyuan;Yu Dan;Xin Shijie(Department of Vascular & Thyroid surgery, The First Affiliated Hospital, China Medical University, Shenyang 110001, China)

机构地区：[1]中国医科大学附属第一医院血管外科,沈阳110001

出　　处：《中华临床医师杂志（电子版）》2017年第11期1881-1885,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金(81170295;81000136);辽宁省科学技术计划项目(2013225086)

摘　　要：目的评价可降解镁支架(BMAS)与316L不锈钢支架对移植静脉吻合口再狭窄的治疗效果,并探索其对内膜增生及内皮化的影响。方法 27只雄性新西兰白兔随机分为可降解镁支架组(BMAS组)、316L不锈钢支架组(316L组)、对照组(NC组),每组9只。3组实验动物均行颈静脉-腹主动脉移植术,术后1个月,BMAS组与316L组经颈动脉入路于静脉桥处分别置入BMAS与316L不锈钢支架,NC组无支架置入。支架置入1、2、3、4个月后观察吻合口管腔直径变化,评价吻合口再狭窄情况;4个月时获取3组移植静脉标本,行EVG染色评价管腔形态及新生内膜面积;Evans blue染色,分光光度仪中测量620 nm波长的OD值,评价血管再内皮化情况。结果两种支架均可有效支撑吻合口,改善吻合口管腔直径丢失,BMAS力学支撑效果可媲美不锈钢支架,且4个月时BMAS导致的血管新生内膜面积与对照组类似[(4.80±0.58)mm^2,vs.(4.17±0.56)mm^2,P=0.112],明显少于不锈钢支架[(6.97±0.78)mm^2,P<0.001];Evans Blue染色结果显示,4个月时316L组OD值明显高于其他2组[316L vs.NC:(0.19±0.03)vs.(0.09±0.01),P=0.001;316Lvs.BMAS:(0.19±0.03)vs.(0.08±0.01),P=0.001],而BMAS组与对照组无差别[(0.08±0.01)vs.(0.09±0.01),P=0.940]。结论 BMAS可以有效支撑狭窄的移植静脉吻合口,力学支撑效果不弱于316L不锈钢支架,同时在减少新生内膜增殖及促进内皮化方面明显优于316L不锈钢支架,可作为未来防治移植静脉再狭窄的潜在性方法。Objective To evaluate the effect of biodegradable magnesium alloy stent andstainless steel316L stent in vein graft anastomotic restenosis,and the influence on vascular remodeling.Methods27male New Zealand white rabbits were divided into3groups(n=9in each group),anesthetizedby3%sodium pentobarbital.External jugular vein was anastomosis to infra-renal abdominal aorta with9-0suture.1month after operation,two type of stents were randomly implanted in the stenosis anastomosisof vein graft.Biodegradable magnesium alloy stent(BMAS)were implanted in BMAS group.316L stainlesssteel stent were implanted in316L group,while control group(NC)did not receive stent implanting.DSAwas carried out through ear vein at months1,2,3and4after stent implantation to measure the infra-renalabdominal aorta and vein graft anastomosis diameter.Paraffin section of the vein graft were performedElastin and Van Gieson stain to evaluate vascular morphology and neointimal area.Evans blue stainingwas performed and detected OD value at a wavelength of620nm to evaluate the process of vascular re-endothelialization.Results Both stents can effectively support the anastomotic,and reduce loss oflumen diameter,the mechanical support effect of biodegradable magnesium alloy stent is not inferior to thatof stainless steel stent.The neointimal area induced by biodegradable magnesium stent was similar to thatof control group at4th month[(4.80±0.58)mm2,vs.(4.17±0.56)mm2,P=0.112],which was significantlysmaller than the control group[(4.80±0.58)mm2,vs.(6.97±0.78)mm2,P<0.001].The OD value of316Lgroup was obviously higher than the other two groups[316L vs.NC:(0.19±0.03)vs.(0.09±0.01),P=0.001;316L vs.BMAS:(0.19±0.03)vs.(0.08±0.01),P=0.001]at4th month,while BMAS group and controlgroup showed no significant difference[(0.08±0.01)vs.(0.09±0.01),P=0.940].Conclusion BMAS caneffectively support the narrow vein graft anastomosis after implantation,which is similar to316L stainlesssteel stent in mechanical support.However,BMAS was superior to316L stent in reducing

关 键 词：可降解镁支架 移植静脉 再狭窄 内膜增生 内皮化 

分 类 号：R654[医药卫生—外科学]