CAJ | 학술논문

目的：探讨新型药物洗脱球囊（DEB）在下肢动脉狭窄性病变（PAD）中可能具有的抑制管腔丢失、减少内膜增生作用。方法以雄性新西兰纯种兔（体重2.5～3.0 kg）为实验对象，于兔腹主动脉近心端及远心端各植入Mustang裸支架1枚，模拟PAD模型，并分别用裸球囊（PTA组）及药物洗脱球囊（DEB组）在血管支架段行后扩张，术后28 d处死动物，收集腹主动脉支架标本，塑料包埋并行Masson染色，比较各组内膜增生程度，同时行DEB药物（紫杉醇）靶点β-微管蛋白免疫组化检测。结果形态学上，与PTA组比较，DEB组内膜增生及管腔狭窄率明显下降。同时β-微管蛋白免疫组化检测显示，与PTA组相比，DEB组血管内膜β-微管蛋白表达量显著增加。结论动物实验初步显示，DEB具有潜在的有效地抑制管腔丢失、减少内膜增生作用，初步证实该新型DEB的优良性能，提示该新型DEB远期应用于临床治疗PAD的潜在可能性。
목적：탐토신형약물세탈구낭（DEB）재하지동맥협착성병변（PAD）중가능구유적억제관강주실、감소내막증생작용。방법이웅성신서란순충토（체중2.5～3.0 kg）위실험대상，우토복주동맥근심단급원심단각식입Mustang라지가1매，모의PAD모형，병분별용라구낭（PTA조）급약물세탈구낭（DEB조）재혈관지가단행후확장，술후28 d처사동물，수집복주동맥지가표본，소료포매병행Masson염색，비교각조내막증생정도，동시행DEB약물（자삼순）파점β-미관단백면역조화검측。결과형태학상，여PTA조비교，DEB조내막증생급관강협착솔명현하강。동시β-미관단백면역조화검측현시，여PTA조상비，DEB조혈관내막β-미관단백표체량현저증가。결론동물실험초보현시，DEB구유잠재적유효지억제관강주실、감소내막증생작용，초보증실해신형DEB적우량성능，제시해신형DEB원기응용우림상치료PAD적잠재가능성。
Objective To investigate the possible inhibition effect of a domestic novel drug-eluting balloon(DEB), such as controlling the vascular stenosis and reducing the intimal hyperplasia, on obstructive peripheral arterial disease (PAD) of lower extremity. Methods Male New Zealand rabbits (weighted 2.5-3.0 kg) were used for this study. Mustang bare metal stents (BMS) were separately implanted at both the proximal and distal site of abdominal aorta to establish the PAD models in rabbits. Bare balloon (PTA group) or drug-eluting balloon (DEB group) was separately used to dilate the stent segment of the aorta. The animals were sacrificed 28 days after the treatment. The aorta stent specimens were collected and sent for pathologic examination. Using Masson staining method the degree of intimal hyperplasia was estimated and the expression level of paclitaxel-targeted β-tubulin was determined with immunohistochemical method. The results were compared between the two groups. Results Morphologically, both the degree of intimal hyperplasia and the vascular stenosis rate in DEB group were significantly lower than those in PTA group. Meanwhile, immunohistochemical examination of paclitaxel-targeted β-tubulin indicated that its expression level in DEB group was obviously higher than that in PTA group. Conclusion This experimental study indicates that the domestic novel DEB has potential inhibition effect in respect of controlling the loss of lumen as well as reducing the intimal hyperplasia. This novel DEB carries excellent property, suggesting the possibility to use DEB in clinical treatment of PAD.