摘要
目的探讨小型猪冠状动脉支架置入术后血管壁炎症反应与新生内膜增生的关系。方法20只健康小型猪随机分入A组(L316不锈钢裸金属支架组)、B组(605L钴铬合金裸金属支架组)、C组(PLGA涂层605L支架组)和D组(PLGA涂层605L雷帕霉素洗脱支架组)。对每只猪于左前降支和右冠状动脉各置入同种支架1枚,至4周时取支架段冠状动脉切片、染色、镜检,测量冠状动脉壁炎症面积与新生内膜面积,分析其相关性。结果A、B、C、D组新生内膜面积分别为(2.09±0.90)、(2.11±1.07)、(1.42±0.35)、(0.64±0.38)mm2,D组显著小于其他各组(P均<0.001),A、B、C组间差异无统计学意义(P>0.05)。A、B、C、D组的中位炎症面积分别为0.22、0.21、0.09、0.00mm2,D组也显著小于其他各组(P=0.009),A、B、C组间差异无统计学意义(P>0.05)。双变量相关分析显示,炎症面积与新生内膜面积间呈显著正相关(r=0.719,P<0.001);在控制支架种类、平均损伤积分和外弹力板围绕面积后,偏相关分析显示两者依然呈显著正相关(r=0.498,P=0.01)。结论炎症可促进冠状动脉支架置入术后新生内膜的增生。雷帕霉素洗脱支架可减少支架置入术后的炎症反应。
Objective To study the relationship between inflammation and neointimal proliferation after coronary stent implantation in porcine model. Methods Twenty normal minipigs were randomly divided into group A （implanted with 316L bare metal stents） , group B （implanted with 605L bare metal stents） , group C （ implanted with PLGA coating 605 L stents）, and group D （ implanted with rapamycin-loaded PLGA coating 605 L stents）. Each minipig was implanted with two same stents in left anterior descending artery and right coronary artery. Four weeks later, the animals were sacrificed and histomorphometric measurements on the stent-segment coronary arteries were made to calculate the correlation between inflammation area and neointimal area. Results Group D had the smallest neointimal area [ （0.64 ± 0. 38 ） mm^2, P 〈 0. 001 ] and inflammation area （ median 0.00 mm^2 , P = 0. 009 ） among all the groups, while there were no statistical differences among group A, B, and C in neointimal area [ （2.09 ± 0. 90）, （2.11 ± 1.07 ）, and （ 1.42 ± 0.35 ） mm^2, respectively ] and in inflammation area （0.22 , 0.21, and 0.09 mm^2 , respectively）. Bivariate correlation analysis showed that the inflammation area was positively correlated with the neointimal area （ P 〈 0. 001, eorrelation coefficient =0. 719）. When stent type, mean injury score, and EEL area were adjusted, partial correlations analysis showed that the inflammation area was still positively correlated with the neointimal area （P = 0. 01, correlation coefficient = 0. 498）. Conclusions Inflammation promotes the neointimal proliferation after coronary stent implantation. Sirolimus-eluting stent may reduce the inflammatory response.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2009年第3期365-369,I0006,共6页
Acta Academiae Medicinae Sinicae
关键词
炎症
再狭窄
药物洗脱支架
inflammation
restenosis
drug-eluting stent
