CAJ | 학술논문

背景：生物可降解支架的出现为第四次冠状动脉介入治疗革命带来新的曙光，不仅可以解决术后血管急性闭塞的问题，还可以在一定的时间后完全吸收。 　　目的：综述可降解冠状动脉支架的应用现状。 　　方法：通过PubMed，CBM，embase等检索数据库搜索近年来可降解血管内支架相关研究内容。 　　结果与结论：可降解聚合物支架、可降解镁合金支架及可降解铁合金支架为目前主要研究的3大生物可降解支架系统。大量临床试验已证明生物全降解支架的长期安全性和可靠性，不久的将来必将取代现有的药物涂层支架，成为经皮冠状动脉介入治疗的主要手段。目前生物全降解支架仍有其局限性，体现在支架的机械性能和降解速率及两者之间的关系，以及暂时未进行复杂冠状动脉病变临床试验。血管恢复正常的生理功能需要6-12个月，支架在12-24个月之内降解可以认为是合理的。目前得到广泛认可的是聚乳酸与聚羟基乙酸共聚形成的聚(乙交脂/丙交脂)二元共聚物作为支架的骨架，通过调节聚乳酸与聚羟基乙酸的比例可以在支架力学性能和降解速率这两者之间取得一个较为合适的平衡。让这种支架既具有良好的力学性能，又能在血管恢复正常生理功能以后完全生物降解。
배경：생물가강해지가적출현위제사차관상동맥개입치료혁명대래신적서광，불부가이해결술후혈관급성폐새적문제，환가이재일정적시간후완전흡수。 　　목적：종술가강해관상동맥지가적응용현상。 　　방법：통과PubMed，CBM，embase등검색수거고수색근년래가강해혈관내지가상관연구내용。 　　결과여결론：가강해취합물지가、가강해미합금지가급가강해철합금지가위목전주요연구적3대생물가강해지가계통。대량림상시험이증명생물전강해지가적장기안전성화가고성，불구적장래필장취대현유적약물도층지가，성위경피관상동맥개입치료적주요수단。목전생물전강해지가잉유기국한성，체현재지가적궤계성능화강해속솔급량자지간적관계，이급잠시미진행복잡관상동맥병변림상시험。혈관회복정상적생리공능수요6-12개월，지가재12-24개월지내강해가이인위시합리적。목전득도엄범인가적시취유산여취간기을산공취형성적취(을교지/병교지)이원공취물작위지가적골가，통과조절취유산여취간기을산적비례가이재지가역학성능화강해속솔저량자지간취득일개교위합괄적평형。양저충지가기구유량호적역학성능，우능재혈관회복정상생리공능이후완전생물강해。
BACKGROUND:The appearance of biodigradable stents brings a new dawn for the fourth coronary intervention revolution. They not only can solve the problem of postoperative acute occlusion of blood vessels, but also can be completely absorbed after a certain time. OBJECTIVE: To summarize the application status of biodegradable coronary stents. METHODS:PubMed, CBM and embase were searched for articles related to biodegradable intravascular stents. RESULTS AND CONCLUSION:Biodegradable polymer stents, biodegradable magnesium stents and biodegradable iron stents are currently the three major research biodegradable stent systems. Numerous clinical trials have demonstrated the long-term safety and reliability of the biological degradation stents, and in the near future they wil replace the existing drug-eluting stents as the primary means of percutaneous coronary intervention. Biodegradable stents currently stil have their limitations, which are reflected in the relationship between mechanical properties and degradation rate and cannot be applied to complicated coronary patients temporarily. It takes 6-12 months to restore normal physiological function of blood vessels, and it can be considered reasonable that degradation of stents is completed in 12-24 months. Poly(lactic-co-glycolic) produced by polylactic acid and polyglycolic acid is currently widely recognized as the stent’s framework. We can get a more appropriate balance between the mechanical properties of the stent and the degradation rate by adjusting the ratio of polylactic acid and polyglycolic acid. This stent not only has good mechanical properties, but also can be completely biodegradable after the restoration of normal function of blood vessels, which has a broad research space.