抑制内膜增生,任重而道远

对于动脉粥样硬化病变血管,诸如球囊血管成形术、支架植入及冠状动脉搭桥等血运重建术后的再狭窄仍是制约心血管介入治疗技术的最主要瓶颈之一。再狭窄主要由新生内膜增生和血管的缩窄性重构导致的结果,而新生内膜增生则是对血管损伤及低血流动力学状态下的一种血管性反应,包括一系列复杂的信号通路和生物效应过程,如炎症、血栓形成、血管平滑肌细胞增殖迁移等。因此,我们应该分阶段、多方向的预防再狭窄的发生。

A Long Way to Go in the Prevention of Intimal Hyperplasia

Arterial reconstruction procedures,including balloon angioplasty,stenting and coronary artery bypass,are used to restore blood flow in atherosclerotic arteries.However,restenosis of these arteries remains a major limitation of the application of these procedures.Restenosis results from two major processes: neointimal hyperplasia and constrictive remodeling.Neointimal hyperplasia is an adaptive response by blood vessels to both injury and low flow hemodynamic states that include a series of complex signaling pathways and processes involving inflammation,thrombosis,and the proliferation and migration of vascular smooth muscle cells.The prevention of restenosis requires a multistage approach.