莪术组分涂层支架预防猪冠状动脉再狭窄的研究

目的通过中华实验用小型猪冠状动脉再狭窄模型,观察中药莪术组分涂层支架抑制内膜增殖的有效性。方法将18只小型猪随机分为莪术组分涂层支架组(ZES组)、雷帕霉素涂层支架组(SES组)及金属裸支架组(BMS组),每组6只,分别在左前降支、左回旋支及右冠状动脉置入同一种支架各1枚。术后30 d冠状动脉造影后将猪处死,观察支架血管段的病理形态及影像学变化。结果 30 d时,与BMS组比较,ZES组和SES组平均管腔直径和平均管腔面积均明显增大(P<0.05),直径狭窄率和面积狭窄率明显减小(P<0.05);与SES组比较,ZES组和BMS组炎症积分明显降低,内皮化积分明显升高(P<0.05);3组损伤积分比较,差异无统计学意义(P>0.05);光学相干断层扫描及扫描电镜观察,SES支架组30 d时可见部分支架节段内皮化不全及炎性细胞浸润。结论 ZES支架可有效地抑制血管内膜增殖,具有良好的生物相容性。

Zedoary component eluting stent protects porcine against coronary artery restenosis

Objective To observe the inhibitory effect of zedoary component eluting stent(ZES) on proliferation of tunica intima in a porcine coronary artery restenosis model.Methods Eighteen porcines were randomly divided into ZES group,sirolimus eluting stent(SES) group,and bare metal stent(BMS) group,6 in each group.A stent was implanted into the decending anterior branch,left circumflex branch and right coronary artery of the animals,respectively.The animals that underwent coronary arteriography were killed 30 days after operation.Pathological morphology and imaging of stents impanted into the decending anterior branch,rotatory branch and right coronary artery were observed.Results The average lumen diameter and area were significant larger while the stenosis rate was significantly lower in ZES and SES groups than in BMS group 30 days after operation(P<0.05).The inflammation score was significantly lower while the endothelial plasia score was significantly higher in ZES and BMS groups than in SES group(P< 0.05).No significant difference was found in injury score among the 3 groups(P>0.05).Optical coherent tomoscanning and scanning electron microscopy showed incomplete endothelial plasia and inflammatory cell infiltration in some stents of SES group 30 days after operation.Conclusion ZES can effectively inhibit the proliferation of vascular tunica intima with a good biocompatibility.