支架内再狭窄表观遗传调控通路研究进展  

Research progress on epigenetic regulatory pathways of in-stent restenosis

作　　者：窦文朝 彭瑜[2,3] 张钲 DOU Wen-chao;PENG Yu;ZHANG Zheng(The First Clinical Medical College,Lanzhou University,Lanzhou 730000,China;Heart Center,the First Hospital of Lanzhou University,Lanzhou 730000,China;Gansu Provincial Clinical Research Center for Cardiovascular Diseases,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院心脏中心,甘肃兰州730000 [3]甘肃省心血管病临床医学研究中心,甘肃兰州730000

出　　处：《中国介入心脏病学杂志》2024年第11期648-652,共5页Chinese Journal of Interventional Cardiology

基　　金：甘肃省心血管病临床医学研究中心(18JR2FA005)。

摘　　要：经皮冠状动脉介入治疗(PCI)是当今冠状动脉疾病的主要治疗方法。尽管药物洗脱支架(DES)技术不断发展,在第二代DES置入后,仍有约10%左右的患者发生支架内再狭窄(ISR)。ISR的特征是支架内进行性管腔狭窄,这是PCI诱导的目标节段动脉壁机械损伤的结果。ISR的病理生理机制尚不清楚,但目前认为血管炎症、血小板活化、血管平滑肌细胞(VSMCs)增殖和迁移以及细胞外基质重塑是导致动脉腔重新狭窄的新内膜增生的原因,从而形成ISR的发生和演变。因此,本综述探讨了PCI术后表观遗传调控下ISR的分子病理机制,为抑制VSMCs增殖、迁移而不影响血管内膜再内皮化寻找更为精准、有效的靶点以预防ISR的发生发展。Percutaneous coronary intervention(PCI)is the main treatment for coronary heart disease.Despite the continuous development of drug-eluting stent(DES)technology,about 10%of patients still develop in-stent restenosis(ISR)after second-generation DES implantation.ISR is characterized by progressive lumen stenosis within the stent,which is the result of PCI-induced mechanical damage to the arterial wall of the target segment.The pathophysiological mechanism of ISR is not well understood,but it is currently thought that vascular inflammation,platelet activation,vascular smooth muscle cells(VSMCs)proliferation and migration,and extracellular matrix remodeling are responsible for neointimal hyperplasia leading to arterial lumen re-stenosis,resulting in the occurrence and evolution of ISR.Therefore,this review explored the molecular pathological mechanism of ISR under epigenetic regulation after PCI,and found more precise and effective targets to prevent the occurrence and development of ISR in order to inhibit the proliferation and migration of VSMCs without affecting the reendothelialization of vascular intima and endothelialization.

关 键 词：经皮冠状动脉介入治疗 支架内再狭窄 表观遗传调控 信号通路 

分 类 号：R54[医药卫生—心血管疾病]