【摘要】 目的探讨猪冠状动脉介入术后内弹力板损伤对术后再狭窄的影响,初步探讨其中可能的机制。方法制作猪冠状动脉介入损伤模型,测量介入术后即刻弹性回缩以及远期内膜增生的程度,分析内弹力板损伤程度与上述指标的关系。结果 30份血管标本均存在不同程度的损伤,平均损伤积分(injury score)为3.08±1.11。血管弹性回缩的平均值为(0.05±0.03)mm,多元回归及曲线拟合结果显示,内弹力板损伤是影响血管弹性回缩量的最重要因素;内弹力板损伤对介入术后远期内膜增生的的影响程度最大,单独存在内弹力板破损的血管段其内膜增生的程度明显高于仅仅有轻度内皮细胞脱落的血管段,其新生内膜面积和厚度分别是后者的2.44倍和2.51倍。结论冠状动脉介入术后内弹力板损伤对再狭窄的影响是关键性的,可能作为预测介入术后再狭窄的一项检测指标。更多还原

【Abstract】 Objective To investigate the influences of internal elastic lamina (IEL) injury on prognosis after PCI in porcines. Methods Thirty pigs were used and their coronary arteries were injured by dilatation of balloons of different sizes. Quantitative angiographic analysis was used to evaluate acute elastic recoil and long-term lumen. Morphological measurements include injury score,IEL injury score and neointimal thickness were performed. The relationships between injury scores and other factors were found with statistical methods and shown with formulas. Results Our data suggest that degree of arterial injury was positively correlated to balloon size as previously reported. The mean level of elastic recoil was (0.05±0.03)mm and was found to be an important factor indicator of IEL injury. Lumen gain was positively correlated to Balloon/artery (B/A) ratio and injury score. The correlative curves were all conic rising steadily first and rapidly hereafter. Neointimal thickness,neointimal area and counts of inflammatory cells had a positive correlation to injury score and the correlative curves were all cubics like an "S". The injury of internal elastic lamina (IEL) was the most critical factor of above curves. Conclusion These experimental data suggest that the injury of IEL is the key factor determining the prognosis of PCI.更多还原