川芎嗪洗脱支架对猪冠状动脉平滑肌细胞增殖和凋亡影响.docVIP

川芎嗪洗脱支架对猪冠状动脉平滑肌细胞增殖和凋亡影响 　　［摘要］ 目的 观察川芎嗪洗脱支架(TES)对平滑肌细胞增殖和凋亡的影响。方法 在6只小型猪冠状动脉分别植入TES与金属裸支架(BMS)，术后第28天处死动物，用组织病理学方法检测内膜增殖情况，用免疫组化和TUNEL 法观察TES对平滑肌细胞增殖和凋亡的影响。结果 TES组较BMS组冠状动脉管腔面积增加、支架内新生内膜面积和面积再狭窄百分比减小(P0.05)，BMS组较TES组增殖细胞核抗原(PCNA)细胞阳性率明显增加(P0.05)，TES组较BMS组单位面积内平滑肌细胞(VSMC)凋亡数明显增加(P0.05)。结论 与EMS相比，TES可明显降低支架内再狭窄，显著抑制VSMC增殖、迁移并促进VSMC凋亡。? 　　［关键词］ 川芎嗪；药物洗脱支架；再狭窄? 　　［中图分类号］ R815［文献标识码］ A［文章编号］ 1671-7562(2008)04-0236-04 　　 　　Proliferation and apoptosis of smooth muscle cells after implantation? 　　of tetramethylpyrazine-eluting stents in the porcine coronary artery?? 　　LI Xuan， MA Gen-shan， CHEN Zhong，SU Ya-min， 　　(School of Clinical Medicine,Southeast University， Nangjing 210009 China) 　　 　　Abstract:ObjectiveTo investigate the proliferation and apoptosis of smooth muscle cells(SMCs)after implantation of tetramethylpyrazine-eluting stents(TES). Methods TES and bare-metal stents(BMS)were implanted in coronary arteries of 6 pigs. At the end point time of 28 days， animals were sacrificed and neointimal thickness, antiproliferating cell nuclear antigen(PCNA)of vascular smooth muscle cell(VSMC), apoptosis of VSMC were measured. Results Compared with BMS， luminal area was significantly increased in the TES group(P0.05),while neointimal area and percentage of restenosis were significantly decreased in the TES group(P0.05). The positive ratio of PCNA of BMS group was higher than that of TES group(P0.05).The apoptosis was significantly increased in TES group than that in BMS group?(P0.05). Conclusion In-stent restenosis is reduced in the TES compared with the BMS.TES could inhibit the hyperplasia and migration of VSMC and increas local VSMC apoptosis.? 　　Key words: tetramethylpyrazine;drug-eluting stent; restenosis? 　　(Morden Medical Journal,2008,37:236-239) 　　 　　经皮冠状动脉介入(PCI)治疗是冠心病治疗的一个重要手段，但术后再狭窄一直是影响PCI疗效的主要问题。单纯球囊扩张术由于早期血管弹性回缩及晚期内膜过度增殖、血管再重塑使得术后再狭窄率高达30％～50％。冠状动脉内支架植入术能有效限制血管弹性回缩和动脉再塑型，使PCI术后的再狭窄率明显下降。但由于支架植入术后依然存在内膜增殖，再狭窄发生率仍达20％～30％。药物洗脱支架(DES)通过抑制炎症反应和细胞增殖、延缓血