【摘要】 背景:金属冠状动脉支架植入后发生再狭窄的概率高达20%～30%,为了降低再狭窄发生率,在863项目支持下,探索新型药物涂层支架治疗冠状动脉狭窄的可能性。目的:将药物涂层支架植入小猪冠状动脉狭窄模型,观察其安全性和有效性,以及与金属裸支架的差异性。设计、时间及地点:随机对照,动物实验于2003-11/2004-04在阜外心血管病医院完成。材料:由单体2-(甲基丙烯酰氧基)乙基-2-(三甲基氨基)乙基磷酸酯、甲基丙烯酸十八酯、甲基丙烯酸羟丙酯和甲基丙烯酸(三甲氧)硅基丙酯合成了一种新型类细胞膜涂层材料。方法:21只猪随机分为3组:裸支架组,涂层携载雷帕霉素(120μg/支架)组,单纯涂层支架组。将支架预装到输送系统,使用ToshibaCSII型C臂成像仪造影条件下,将药物支架置入小型猪冠状动脉血管,每只猪置入2枚支架。主要观察指标:使用图像分析仪检测管腔直径,管腔面积,支架上平均内膜厚度,支架间平均内膜厚度,内膜面积,面积再狭窄百分比,损伤指数。结果:置入后28d时,涂层携载雷帕霉素组和裸支架组相比,支架上内膜厚度、支架间内膜厚度、新生内膜面积差异均有显著性意义(P<0.05),其中新生内膜面积涂层携载雷帕霉素组比裸支架组减少了44.87%;虽面积狭窄百分比差异无显著性意义,但P值(0.053)接近0.05;且涂层携载雷帕霉素组无再狭窄发生。结论:涂层携载雷帕霉素支架可显著抑制支架置入后血管内膜增生和再狭窄发生。更多还原

【Abstract】 BACKGROUND:The restenosis occurs up to 20%-30% following metal coronary stent implantation. Under the support of the 863 program,the feasibility to treat coronary artery stenosis using a novel drug-eluting stent (DES) has been investigated to reduce restenosis OBJECTIVE:A drug-eluting stent (rapamycin as drug mode) was implanted into porcine models of coronary stenosis. The safety and efficacy of the drug-eluting stent were observed and compared with bare-metal stent. DESIGN,TIME AND SETTING:A randomized controlled animal experiment was performed in the Fu Wai Hospital for Cardiovascular Disease between November 2003 and April 2004. MATERIALS:A novel bioinspired phospholipid copolymer was synthesized by free radical polymerization of stearyl methacrylate β-hydroxypropyl methacrylateand 3-(trimethoxysilyl) propylmethacrylate. METHODS:Twenty-one pigs were randomly divided into 3 groups:bare-mental stent,drug-eluting stent,and polymer-coated stent. The treated stents pre-loaded onto a delivery system through the use of crimping instrument were implanted into pig’s coronary artery,with 2 stents per pig. MAIN OUTCOME MEASURES:Determination of luminal diameter,luminal area,mean intimal thickness on and between the stents,neointimal area,percentage of luminal area restenosis,and damage index using an image analysis instrument. RESULTS:At 28 days after implantation,there was significant difference in mean intimal thickness on and between the stents,as well as neointimal area,between the DES and bare-metal stent groups (P < 0.05). The neointimal area was reduced by 44.87% in the DES group compared with the bare-metal stent group. No significant difference in percentage of luminal area restenosis was found between the DES and bare-metal stent groups,but P value equaled to 0.053,which was close to 0.05. In addition,no restenosis was found in the DES group. CONCLUSION:Rapamycin DES can markedly resist intravascular intimal hyperplasia and restenosis following stenting.更多还原