雷公藤内酯醇洗脱支架抑制支架内再狭窄及对PCNA、P27kip1表达的影响

目的 研究雷公藤内酯醇洗脱支架对冠脉支架植入术后再狭窄的有效性及安全性,及其对冠脉增殖细胞核抗原(PCNA)、P27kip1表达的影响.方法 采用20只国内杂种幼猪,随机分成裸支架组和雷公藤内酯醇洗脱支架组,每组各植入支架10枚.比较支架植入后4周各组的冠脉造影、组织病理学、免疫组化及血生化结果.结果 雷公藤内酯醇洗脱支架组支架内最小内径相似,大于裸支架组(P＜0.05);雷公藤内酯醇洗脱支架组新生内膜面积小于裸支架(P＜0.05).雷公藤内酯醇洗脱支架组PCNA阳性细胞少于裸支架组(P＜0.05),而P27kip1表达多于裸支架组(P＜0.05).未发现明显的毒副作用.结论 雷公藤内酯醇能抑制新生内膜的形成,在支架植入后4周能预防再狭窄的形成,可能通过影响PCNA和P27kip1蛋白的表达抑制血管平滑肌细胞增殖发挥作用.

Triptolide-eluting stent prevents porcine coronary artery in-stent restenosis by affecting PCNA and P27kip1 expression

Objective To investigate the effectiveness and safety of triptolide-eluting stents implanted in porcine coronary arteries for restenosis prevention,and its effect on the expression of proliferating cell nuclear antigen(PCNA)and P27kip1.Methods Ten triptolide-eluting stents and 10 stainless steel stents(control)were implanted in 20 porcine coronary arteries at random.Four weeks later,angiography of the arteries was performed along with also histopathological and immunochemical examinations.Results The in-stent minimal lumen diameter of triptolide group was significantly greater,and the neointimal area significantly smaller,than those of the control group(P<0.05).PCNA expression was significantly lower while P27kip1 protein significantly higher in triptolide group than in the control group(P<0.05).Conclusion Triptolide-eluting stent can effectively inhibit neointimal formation to prevent restenosis in porcine coronary artery 4 weeks after implantation,probably by inhibiting P27kip1 expression and consequently vascular smooth muscle cell proliferation.