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雷帕霉素-巴曲酶复合药物涂层支架预防支架内再狭窄的实验研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2007年第2期
页码:
185-188
栏目:
临床研究
出版日期:
2007-04-01

文章信息/Info

Title:
Experimental study on rapamycinbatroxobin eluting stent and its prevention of coronary restenosis after angiophaty
作者:
陈丹; 吕安林; 张薇; 苑媛; 刁繁荣; 李军杰
第四军医大学西京医院心血管内科，陕西 西安 710032
Author(s):
CHEN Dan; L Anlin;  ZHANG Wei;  YUAN Yuan;  DIAO Fanrong;  LI Junjie
Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi′an,Shaanxi 710032, China
关键词:
支架; 再狭窄; 雷帕霉素; 巴曲酶
Keywords:
stent; restenosis; rapamycin; batroxobin
分类号:
R541. 4
DOI:
-
文献标识码:
A
摘要:
目的 评价雷帕霉素巴曲酶复合药物涂层支架对再狭窄和支架内血栓的防治作用及安全性，减少术后抗血小板药物的应用及并发症的发生率。方法 采用随机、双盲试验在16头微型猪的冠状动脉前降支或左旋支分别置入支架1枚，其中雷帕霉素涂层支架（每枚支架药物剂量1.2 μg/mm2）共8枚，为对照组；雷帕霉素巴曲酶复合药物涂层支架（每枚支架含雷帕霉素1.2 μg/mm2、巴曲酶0.3 μg/mm2）共8枚，为实验组。对照组术前3 d起每天口服氯吡格雷75 mg和阿司匹林0.3 g直至28 d处死；实验组术前3 d至术后7 d每天口服氯吡格雷75 mg和阿司匹林0.3 g，此后改为每天口服阿司匹林0.3 g，直至28 d处死。28 d时进行冠状动脉造影随访，术后处死动物，取出支架血管，进行组织学分析。结果 再狭窄率：对照组为 0 ，实验组为 0。管腔丢失率：对照组为(7±5)%，实验组为(4±3)%。新生内膜面积：对照组为（1.0 ±0.8）mm2，实验组为（0.9 ±0.7）mm2。结论 雷帕霉素-巴曲酶复合药物涂层支架与单纯雷帕霉素涂层支架比较可以减少支架置入术后的口服氯吡格雷总量及用药时间。
Abstract:
AIM To determine the efficacy of stent coated with combined rapamycin (Rapa) and batroxobin (Batr) in reducing the neohyperplasia of vascular endothelium, thrombogenesis and the incidence of complications after angiophaty. METHODS Sixteen miniature pigs with a stent implanted in the coronary arteries were divided in 2 groups randomly and doubleblindly. Stents were coated with PLGA (poly/lacticcoglycolic acid) polymer containing 1.2 μg/mm2 Rapa (Rapa group) or 1.2 μg/mm2 Rapa and 0.3 μg/mm2 Batr (Com group). Clopidogrel 75 mg and aspirin 0.3 g were given from 3 days before operation till 28 days after operation in Rapa group. Clopidogrel and aspirin of the same dosages were also given in Com group from 3 days before operation to 7 days after operation, and then only aspirin 0.3 g was given till the 28th day. On the 28th day, coronary arteriographies were conducted and the pigs were sacrificed. Stents were taken out for histological analysis. RESULTS There was no restenosis in both Com and Rapa groups. The average stenosis degree was （7±5）% in Rapa group and （4±3）% in Com group. Square of the neohyperplasia vascular endothelium was （1.0±0.8）mm2 in Rapa group and （0.9±0.7）mm2 in Com group. CONCLUSION Compared with Rapacoated stents, the application of Rapa+Batrcoated stents can reduce the dosage and duration of Clopidogrel.

参考文献/References

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［5］Poon M，Marx SO，Gallo R，et al. Rapamycin inhibits VSMC migration［J］. Clin Invest，1996，98(10): 2277-2283.

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［7］Gallo R，Padurean A，Jauaraman T，et al. Inhibition of intimal thickening after balloon angioplasty in porcine coronary arteries by targeting regulators of the cell cycle［J］. Circulation，1999，99(16): 2164-2170.

［8］Suzuki T，Kopia G,Hayashi S, et al. Stentbasde delivery of sirolimus reduces neointimal formation in a porcine coronary model［J］. Circulation，2001，104(10): 1189-1193.

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备注/Memo

备注/Memo:
收稿日期：2006-03-02.通讯作者：吕安林，副主任医师，副教授，主要从事冠心病介入治疗研究Email: lvanlin@fmmu.edu.cn 作者简介：陈丹，主治医师，硕士Email: chendan@fmmu.edu.cn
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