抗CD34抗体抵消雷帕霉素洗脱支架内皮延迟修复研究

目的:雷帕霉素洗脱支架在降低再狭窄风险的同时,通过抑制血管再内皮化,可能增加支架内血栓发生风险,抗CD34抗体通过特异捕获血液中内皮祖细胞,加速支架术后血管再内皮化。本研究目的是将抗CD34抗体涂敷到雷帕霉素洗脱支架上,通过实验小猪支架术后不同时间造影,随访评价抗CD34抗体对雷帕霉素洗脱支架早期再内皮化的影响。方法:将3种不同类型的支架包括金属裸支架(bare-metal stents,BMS)、雷帕霉素洗脱支架(sirolimous-eluting stents,SES)和抗CD34抗体与雷帕霉素洗脱联合支架(anti-CD34 antibody and sirolimous-eluting combined stents,ASES)随机植入到符合条件的10头中华小型猪冠状动脉内(共植入了6个BMS、7个支架和7个ASES),支架植入术后2 w,进行冠状动脉造影及冠状动脉内光学相干断层成像(optical coherence tomography,OCT)检查;动物处死后,对支架段冠状动脉进行病理组织学检查及扫描电镜观察。结果:1.通过对冠状动脉造影、OCT图像及支架段冠状动脉的病理组织学的观察分析,均未发现支架内血栓及小的附壁血栓。2.在2 w OCT检查图像上,ASES新生内膜覆盖率显著高于SES(55.56±35.27)%vs.(41.82±23.28)%,P=0.047],ASES平均内膜覆盖厚度不但显著高于SES(89±5.0)μm vs.(32±4.9)μm,P<0.001]、还高于BMS(89±5.0)μm vs.(44±7.2)μm,P=0.001]。病理组织学观察及扫描电镜观察也显示,ASES和BMS新生内膜覆盖水平及质量均优于SES。结论:将抗CD34抗体联合应用到雷帕霉素洗脱支架上,能够显著抵消后者在支架术后早期对再内皮化的抑制作用。

The union of anti-CD34 antibody can offset the inhibitory effect of sirolimous-eluting stents on the reendothelialization

Objective:Though sirolimous-eluting stents can reduce the risk of restenosis,it may increase the risk of in-stent thrombosis by delaying the re-endothelialization after stenting.Anti-CD34 antibody may improve the re-endothelialization after stenting by specifically capturing the endothelial progenitor cells in blood.The aim of this study is to investigate the effects of the union of anti-CD34 antibody to sirolimous-eluting stents on the short-term re-endothelialization.Methods:Three different types of stent...