CAJ | 학술논문

目的研究雷公藤内酯醇涂层支架(triptolide eluding stent,TES)置入猪冠状动脉后对血管内膜增生、炎性因子激活、血管损伤、术后再狭窄的影响及支架的安全性.方法 12只健康小型猪随机分为3组,分别植入雷公藤内酯醇涂层支架(100μg)、雷帕霉素洗脱支架(parter)、裸金属支架(每组12枚).每只猪冠状动脉前降支、回旋支、右冠状动脉各植入一枚支架,术后给予抗血小板药物,12周后复查冠状动脉造影(QCA)分析管腔变化、组织病理、血常规、生化结果,免疫组化榆测支架处血管VEGF,ICAM-1,α-actin的变化.结果各组支架植入顺利,12周内无死亡,血管损伤积分无差异,管腔内均无血栓形成.裸支架组支架部位血管腔面积(3.76±0.61)mm2、最小管腔内径(2.15±0.18)mm小于TES组[(5.13±0.46)mm2,(2.65±0.21)mm]和DES组[(5.01±0.54)mm2,(2.65±0.25)mm,P＜0.01];裸支架内增生内膜面积及内膜增生程度裸支架组大于TES组和乐普支架组(P＜0.05),裸支架组支架部位血管内膜VEGF,ICAM-1,α-actin表达明显强于TES和乐普支架组.支架植入前后各组动物血细胞计数和肝肾功能无明显变化.结论雷公藤内酯醇洗脱支架能抑制血管新生内膜增殖和炎性因子的表达,在支架植入12周后能有效地预防再狭窄.
목적 연구뢰공등내지순도층지가(triptolide eluding stent,TES)치입저관상동맥후대혈관내막증생、염성인자격활、혈관손상、술후재협착적영향급지가적안전성.방법 12지건강소형저수궤분위3조,분별식입뢰공등내지순도층지가(100μg)、뢰파매소세탈지가(parter)、라금속지가(매조12매).매지저관상동맥전강지、회선지、우관상동맥각식입일매지가,술후급여항혈소판약물,12주후복사관상동맥조영(QCA)분석관강변화、조직병리、혈상규、생화결과,면역조화유측지가처혈관VEGF,ICAM-1,α-actin적변화.결과 각조지가식입순리,12주내무사망,혈관손상적분무차이,관강내균무혈전형성.라지가조지가부위혈관강면적(3.76±0.61)mm2、최소관강내경(2.15±0.18)mm소우TES조[(5.13±0.46)mm2,(2.65±0.21)mm]화DES조[(5.01±0.54)mm2,(2.65±0.25)mm,P＜0.01];라지가내증생내막면적급내막증생정도라지가조대우TES조화악보지가조(P＜0.05),라지가조지가부위혈관내막VEGF,ICAM-1,α-actin표체명현강우TES화악보지가조.지가식입전후각조동물혈세포계수화간신공능무명현변화.결론 뢰공등내지순세탈지가능억제혈관신생내막증식화염성인자적표체,재지가식입12주후능유효지예방재협착.
Objective To observe the effect of a triptolide-eluting stent(TES)on neointimal hyperplasia in response to vascular injury,inflammation and safety to prevent restenosis after angioplasty.Method Twelve pigs were randomly divided into three groups and received either a bare metal stent(BMS),a sirolimus-eluting stent (SES)or a TES.Each pig was treated with antiplatelet drugs after angioplasty.Biochemistry,vascular morphometry,histopathology and immunohistochemistry were analyzed at 12 weeks after angioplasty.Results The injury scores of the blood vessel were similar in all three groups.There were no differences in minimal lumen diameter or lumen area between the TES[(5.13 ±0.46)mm2;(2.65 ± 0.21)mm]and SES[(5.01±0.54)mm2;(2.65±0.25)mm]groups,but they were significantly(P＜0.01)larger than those in the BMS group[(3.76±0.61)mm2;(2.15 ±0.18)mm].The neointimal area in the TES group was smaller than that in the BMS group,but was similar to that in the SES group.The expression of VEGF,ICAM-1 and α-actinin were significantly lower in the TES group than in the BMS group.In all groups,the proliferation on both edges of the stents was insignificant.No toxicity was found in the TES group.Conclusions TES inhibits neointimal proliferation and the expression of inflammatory factors in pigs.In this study,TES safely and effectively prevented restenosis for 12 weeks.