CAJ | 학술논문

目的:评估雷帕霉素药物洗脱支架(SES)对糖尿病小型猪冠状动脉支架置入后内膜增生的作用.方法:建立链脲菌素诱导的糖尿病小型猪模型(糖尿病组,n=12),随机选取2支冠状动脉置入SES,共计置入24枚支架,术后饲养6个月,与非糖尿病置入SES支架的小型猪模型(对照组,n=12)比较冠状动脉造影、血管内超声及组织切片检查结果.结果:两组动物支架置入冠状动脉分布,术前参照血管直径[糖尿病组:(2.78±0.35)mm,对照组:(2.81±0.29)mm]及术后即刻最小管腔内径[糖尿病组:(2.90±0.42)mm,对照组:(2.89±0.33)mm]均相似(P均>0.05).术后6个月糖尿病组支架内狭窄程度[(35.6±9.2)%和(7.9±3.1)%,P<0.001]、支架内晚期管腔丢失[(0.32±0.09)mm和(0.09±0.04)mm,P<0.001]、新生内膜厚度[血管内超声:(0.35±0.12)mm和(0.11±0.08)mm,P<0.05]及新生内膜面积[血管内超声:(1.29±0.51)mm~2和(0.26±0.11)mm~2,P<0.001;组织切片:(1.24±0.76)mm~2和(0.19±0.08)mm~2,P<0.05]均显著高于对照组.结论:糖尿病小型猪冠状动脉置入SES后内膜增生程度显著高于无糖尿病模型.
목적:평고뢰파매소약물세탈지가(SES)대당뇨병소형저관상동맥지가치입후내막증생적작용.방법:건립련뇨균소유도적당뇨병소형저모형(당뇨병조,n=12),수궤선취2지관상동맥치입SES,공계치입24매지가,술후사양6개월,여비당뇨병치입SES지가적소형저모형(대조조,n=12)비교관상동맥조영、혈관내초성급조직절편검사결과.결과:량조동물지가치입관상동맥분포,술전삼조혈관직경[당뇨병조:(2.78±0.35)mm,대조조:(2.81±0.29)mm]급술후즉각최소관강내경[당뇨병조:(2.90±0.42)mm,대조조:(2.89±0.33)mm]균상사(P균>0.05).술후6개월당뇨병조지가내협착정도[(35.6±9.2)%화(7.9±3.1)%,P<0.001]、지가내만기관강주실[(0.32±0.09)mm화(0.09±0.04)mm,P<0.001]、신생내막후도[혈관내초성:(0.35±0.12)mm화(0.11±0.08)mm,P<0.05]급신생내막면적[혈관내초성:(1.29±0.51)mm~2화(0.26±0.11)mm~2,P<0.001;조직절편:(1.24±0.76)mm~2화(0.19±0.08)mm~2,P<0.05]균현저고우대조조.결론:당뇨병소형저관상동맥치입SES후내막증생정도현저고우무당뇨병모형.
Objective:To investigate the effect of rapamycin eluting coronary stent for inhibition of neointimal hyperplasia in diabetic porcine model.Methods:There were two groups in this study. Diabetic group, n=12, diabetic porcine model was established by a single dose of streptozotocin, and rapamycin eluting coronary stents were randomly implanted into 2 of the major epicardial coronary arteries. Control group, n=12, with non-diabetic porcine. The degree of neointimal hyperplasia evaluated by coronary angiography, intravascular ultrasound (IVUS) and histopathology were compared between two groups respectively at 6 months of the event. Results:The distribution of vessels received stents, reference vessel diameters and post-procedural minimal luminal diameter were comparable between two groups. All animals received angiographic follow-up at 6 months of time. In Diabetic group, the degree of stent stenosis (35.6%±9.2% vs. 7.9%±3.1%,P<0.001), late lumen loss (0.32±0.09 mm vs. 0.09±0.04 mm,P<0.001), the thickness of neointima by IVUS examination (0.35±0.12 mm vs. 0.11±0.08 mm,P<0.05) and area stenosis by IVUS (1.29±0.51 mm~2 vs. 0.26±0.11 mm~2, P<0.001); and histopathological examination (1.24±0.76 mm~2 vs. 0.19±0.08mm~2, P<0.05) were significantly higher than those in Control group. Conclusion: The neointimal hyperplasia after rapamycin eluting stent implantation was significantly severe in the diabetic porcine models than those in non-diabetic ones.