可降解冠状动脉支架的应用现状简

背景：生物可降解支架的出现为第四次冠状动脉介入治疗革命带来新的曙光，不仅可以解决术后血管急性闭塞的问题，还可以在一定的时间后完全吸收。 目的：综述可降解冠状动脉支架的应用现状。 方法：通过PubMed，CBM，embase等检索数据库搜索近年来可降解血管内支架相关研究内容。 结果与结论：可降解聚合物支架、可降解镁合金支架及可降解铁合金支架为目前主要研究的3大生物可降解支架系统。大量临床试验已证明生物全降解支架的长期安全性和可靠性，不久的将来必将取代现有的药物涂层支架，成为经皮冠状动脉介入治疗的主要手段。目前生物全降解支架仍有其局限性，体现在支架的机械性能和降解速率及两者之间的关系，以及暂时未进行复杂冠状动脉病变临床试验。血管恢复正常的生理功能需要6-12个月，支架在12-24个月之内降解可以认为是合理的。目前得到广泛认可的是聚乳酸与聚羟基乙酸共聚形成的聚（乙交脂/丙交脂）二元共聚物作为支架的骨架，通过调节聚乳酸与聚羟基乙酸的比例可以在支架力学性能和降解速率这两者之间取得一个较为合适的平衡。让这种支架既具有良好的力学性能，又能在血管恢复正常生理功能以后完全生物降解。

Application situation of degradable coronary stents

BACKGROUND：The appearance of biodigradable stents brings a new dawn for the fourth coronary intervention revolution. They not only can solve the problem of postoperative acute occlusion of blood vessels, but also can be completely absorbed after a certain time. OBJECTIVE： To summarize the application status of biodegradable coronary stents. METHODS：PubMed, CBM and embase were searched for articles related to biodegradable intravascular stents. RESULTS AND CONCLUSION：Biodegradable polymer stents, biodegradable magnesium stents and biodegradable iron stents are currently the three major research biodegradable stent systems. Numerous clinical trials have demonstrated the long-term safety and reliability of the biological degradation stents, and in the near future they wil replace the existing drug-eluting stents as the primary means of percutaneous coronary intervention. Biodegradable stents currently stil have their limitations, which are reflected in the relationship between mechanical properties and degradation rate and cannot be applied to complicated coronary patients temporarily. It takes 6-12 months to restore normal physiological function of blood vessels, and it can be considered reasonable that degradation of stents is completed in 12-24 months. Poly（lactic-co-glycolic） produced by polylactic acid and polyglycolic acid is currently widely recognized as the stent’s framework. We can get a more appropriate balance between the mechanical properties of the stent and the degradation rate by adjusting the ratio of polylactic acid and polyglycolic acid. This stent not only has good mechanical properties, but also can be completely biodegradable after the restoration of normal function of blood vessels, which has a broad research＆nbsp;space.