CAJ | 학술논문

目的:探讨脑血管支架置入后血小板活化和炎性因子的变化与再狭窄的关系.方法:以颅内动脉,支架,狭窄,血小板活化,炎症因子为检索词,检索中国期刊全文数据库(1999-01/2009-06);以intracranial arterial,stents,stenosis,elevated plateletactivation,inflammatory factors为检索词,检索PubMed数据库(1999-01/2009-06),文献检索语种限制为中文和英文.以血小板的活化和炎症因子的变化为评价指标.纳入脑血管支架置入治疗颅内动脉狭窄的临床研究,排除动物实验和其他治疗颅内动脉狭窄的方法.结果:计算机初检得到650篇文献,根据纳入排除标准,对脑血管支架置入后血小板活化和炎性因子的变化与再狭窄的关系进行分析.血小板活化、炎性反应和炎症因子在颅内外血管狭窄支架置入后再狭窄中的作用,目前成为研究的热点.认识支架置入后再狭窄的危险因素对判断支架置入的适应证及有效预防支架置入后再狭窄有重要意义.血小板血栓形成是支架置入后急性血管闭塞的主要原因之一,活化的血小板通过其释放产物加重对内皮细胞的破坏作用,促进平滑肌细胞的过度增殖、迁移.支架本身作为一种外来刺激物,首先引起血小板在支架表面的聚集和激活,分泌出大量的各种细胞因子,导致血栓的形成.随之大量的白细胞将在血管损伤部位聚集后分泌出细胞因子并介导炎症反应,导致平滑肌细胞大量向损伤部位迁移发生增殖反应,由于新生内膜的大量增生,导致血管壁的重构引起支架内再狭窄.结论:置入前常规给予抗血小板治疗,同时控制置入后炎症反应、抑制血管平滑肌细胞增殖将会成为治疗颅内血管狭窄支架置入后再狭窄的有效方法.
목적:탐토뇌혈관지가치입후혈소판활화화염성인자적변화여재협착적관계.방법:이로내동맥,지가,협착,혈소판활화,염증인자위검색사,검색중국기간전문수거고(1999-01/2009-06);이intracranial arterial,stents,stenosis,elevated plateletactivation,inflammatory factors위검색사,검색PubMed수거고(1999-01/2009-06),문헌검색어충한제위중문화영문.이혈소판적활화화염증인자적변화위평개지표.납입뇌혈관지가치입치료로내동맥협착적림상연구,배제동물실험화기타치료로내동맥협착적방법.결과:계산궤초검득도650편문헌,근거납입배제표준,대뇌혈관지가치입후혈소판활화화염성인자적변화여재협착적관계진행분석.혈소판활화、염성반응화염증인자재로내외혈관협착지가치입후재협착중적작용,목전성위연구적열점.인식지가치입후재협착적위험인소대판단지가치입적괄응증급유효예방지가치입후재협착유중요의의.혈소판혈전형성시지가치입후급성혈관폐새적주요원인지일,활화적혈소판통과기석방산물가중대내피세포적파배작용,촉진평활기세포적과도증식、천이.지가본신작위일충외래자격물,수선인기혈소판재지가표면적취집화격활,분비출대량적각충세포인자,도치혈전적형성.수지대량적백세포장재혈관손상부위취집후분비출세포인자병개도염증반응,도치평활기세포대량향손상부위천이발생증식반응,유우신생내막적대량증생,도치혈관벽적중구인기지가내재협착.결론:치입전상규급여항혈소판치료,동시공제치입후염증반응、억제혈관평활기세포증식장회성위치료로내혈관협착지가치입후재협착적유효방법.
OBJECTIVE: To explore the correlation among platelet activation, inflammatory factor changes and vascular restenosis following intravascular stent implantation.METHODS: Chinese Journal Full-Text Database and Pubmed were retrieved using search terms of intracranial arterial, stents,stenosis, elevated platelet activation, and inflammatory factors from January 1999 to June 2009. The language was restricted within Chinese and English. Simultaneously, platelet activation and inflammatory factor changes were acted as evaluation indexes. Accordingly, clinical research regarding treating intracranial artery stenosis with intravascular stent implantation was included. The animal experiment or other treatment methods were excluded.RESULTS: A total of 650 papers were obtained by initial search with computer. According to inclusion criteria, the related papers were analyzed. Platelet activation, inflammatory reaction and inflammatory factor were the focuses of research concerning restenosis following intravascular stent implantation. Platelet thrombus was the main factor to cause acute vascular occlusion, and the activated platelet aggravated the damage of endothelial cells, which induced over proliferation of smooth muscle cell. As a kind of foreign body, the stent implantation was closely associated with complication, such as formation of thrombosis, acute vascular occlusion, vasovagal reflex and immune reaction, which lead to reconstruction of vessel wall and in-stent restenosis.CONCLUSION: It is effective to cure vascular restenosis by undergoing antiplatelet therapy prior to implantation, controlling inflammatory reaction, as well as inhibiting vascular smooth muscle cell proliferation following intravascular stent implantation.