川芎嗪洗脱支架预防支架内再狭窄的实验研究

目的:研究川芎嗪洗脱支架(TES)抑制内膜增生防治再狭窄的效果及其机制。方法:小型猪9只随机分为3组,实验组植入TES(TES组),对照组植入金属裸支架(BMS组)或雷帕霉素洗脱支架(SES组)。术后第28天处死动物,组织病理学检测内膜厚度,免疫组织化学法测定增殖细胞核抗原(PCNA),TUNEL法测细胞凋亡,扫描电镜观察内皮细胞的覆盖情况。结果:术后第28天病理学证实,TES组较BMS组管腔面积增加、支架内新生内膜面积和面积再狭窄百分比减小(P<0.05)。BMS组较TES组PCNA细胞阳性率明显增加(P<0.05),TES组较SES组PCNA阳性率增加(P<0.05)。TES组较BMS组单位面积内平滑肌细胞(VSMC)凋亡数明显增加(P<0.05)。扫描电镜显示TES组和BMS组28 d血管内皮细胞完全覆盖,SES组基本覆盖,但内膜不平整。结论:TES可以显著抑制VSMC增殖、迁移并促进VSMC凋亡,但不影响血管内皮愈合,是防治血管再狭窄的新策略。

Experimental study of preventive effect of tetramethylpyrazine-eluting stents on in-stent restenosis

Objective To assess the preventive effect and mechanism of tetramethylpyrazine(TMP)-eluting stents(TES)on in-stent restenosis in pigs.Methods Nine pigs were randomly divided into TES group,bare-metal stents(BMS) group and sirolimus-eluting stents(SES) group.The TES group was implanted with TES,the BMS group with BMS,the SES group with SES.At the 28th day,animals were executed and neointimal thicknesses,proliferating cell nuclear antigen(PCNA) of vascular smooth muscle cell(VSMC),apoptosis of VSMC were measured.Scan electron microscope was used to observe the covering instances of endothelial cells.Results Comparing with BMS,luminal area was significantly increased in the TES group(P<0.05),while neointimal area and percentage of restenosis were significantly decreased in the TES group(P<0.05).The positive ratio of PCNA of BMS group was higher than that of TES group(P<0.05).The positive ratio of PCNA of TES group was higher than that of SES group.The apoptosis was significantly increased in TES group than that in BMS group(P<0.05).Scan electron microscope indicated complete reendothelialization at the 28th day in BMS and TES groups,but poor endothelium covering in the SES group.Conclusion TES can inhibit the hyperplasia and migration of VSMC and increase VSMC apoptosis,but it has no effect on the healing of endothelium.TES is a promising and new strategy in preventing restenosis.