聚合物涂层改性对药物洗脱支架植入后血管内膜修复的作用

摘要

Objective To evaluate the effect of the implantation of the new sirolimus-eluting stent (SES) with modified polymer on the neointimal inhibition and re - endothelialization in experimental swine. Methods Thirty-two swine were selected for this study. Bare metal stent (BMS, n = 15), new-polymer coated stent (Polymer, n = 17), Firebird2 sirolimus-eluting stent (SES-FB2, re = 17) and new polymer coated SES (SES-Plus, n = 15) were randomly implanted in the coronary arteries. At 7 and 28 days after the procedure, sampling was taken respectively for the analysis of in-stent endothelialization extent with scanning electron microscope. At 28 and 180 days after the treatment, sampling was taken respectively and sent for pathological analysis of neointimal proliferation degree. Results Scanning electron microscopy showed that at 7 days after stent implantation the endothelialization rates in BMS, Polymer, SES-FB2 and SES-Plus groups were 42% ± 16%, 41% ± 17%, 23% ± 11% and 47% ± 21% respectively. The endothelialization rate of SES-FB2 group was significantly lower than that of each of other three groups (P < 0.05). At 28 days after stent implantation the endothelialization rate in SES-FB2 group was only 84% ±21%, while in all the other three groups the endothelialization rate was 100% (P < 0.05). No statistically significant difference in the endothelialization rate existed among BMS, Polymer and SES-Plus groups (P > 0.05). Pathologic examination indicated that at 28 days after stent implantation the neointimal area of SES - FB2 and SES - Plus group was (2.08 ± 0.76) mm2 and (2.28 ± 0.84) mm2 respectively, while at 180 days after stent implantation the neointimal area of SES-FB2 and SES-Plus group was (3.06 ± 1.33) mm2 and (3.19 ± 0.63) mm2 respectively. The differences in neointimal area at 28 and 180 days after stent implantation between SES-FB2 and SES-Plus group were not significant (P > 0.05). Conclusion New polymer coated SES can effectively inhibit neointimal proliferation and promote vascular endothelialization.%目的 研究雷帕霉素洗脱支架聚合物涂层改性促进血管内皮化及抑制内膜增殖的作用.方法 选择32只小型猪,在冠状动脉内随机植入裸支架(BMS)15枚、新型聚合物涂层支架(Polymer) 17枚、FireBird2雷帕霉素洗脱支架(SES-FB2)17枚和新型聚合物涂层的雷帕霉素洗脱支架(SES-Plus)15枚,分别于植入后7、28 d取材,用扫描电镜分析内皮化程度,并分别于28、180 d取材,病理分析内膜增生程度.结果 扫描电镜分析显示,与SES-FB2组相比,支架植入后7d和28 d,SES-Plus组内皮覆盖率显著增加(分别为23％±11％比47％±21％和84±21％比100％,P＜0.05),而BMS、Polymer和SES-Plus三组之间差异无统计学意义(P＞0.05).病理分析显示,支架植入后28 d和180 d,SES-Plus组和SES-FB2组间的新生内膜面积差异无统计学意义[分别为(2.28±0.84) mm2比(2.08±0.76) mm2和(3.19±0.63) mm2比(3.06±1.33) mm2,P＞ 0.05].结论 SES-Plus能有效抑制内膜增生,具有明显的促进内皮化作用.