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抗CD34抗体优化雷帕霉素洗脱支架疗效的实验研究
  • ISSN号:0253-3758
  • 期刊名称:《中华心血管病杂志》
  • 时间:0
  • 分类:R543.3[医药卫生—心血管疾病;医药卫生—临床医学;医药卫生—内科学]
  • 作者机构:[1]首都医科大学附属北京安贞医院心内科,100029
  • 相关基金:国家自然科学基金(基金号30770581);北京市科技新星项目(2007A001)
中文摘要:

目的评价抗CD34抗体对雷帕霉素洗脱支架早期再内皮化以及远期抗再狭窄的影响。方法将裸金属支架(BMS)、雷帕霉素洗脱支架(SES)和抗CD34抗体与雷帕霉素洗脱联合支架(ASES)随机置入到22头中华小型猪的冠状动脉内(共置入15枚BMS、17枚SES和16枚ASES)。10头中华小型猪在置入支架(共置入6枚BMS、7枚SES和7枚ASES)后2周,另外12头中华小型猪在置入支架(共置入9枚BMS、10枚SES和9枚ASES)后3个月,进行冠状动脉造影及冠状动脉内光学相干断层成像(OCT)检查,并在处死动物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)支架术后2周,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均未发现支架内血栓及小的附壁血栓。对OCT图像的分析显示,ASES新生内膜覆盖率显著高于SES[(55.56±35.27)%比(41.82±23.28)%,P〈0.05];ASES平均内膜覆盖厚度不但显著高于SES[(89.0±5.0)μm比(32.0±4.9)μm,P〈0.01],而且显著高于BMS[(89.0±5.0)μm比(44.0±7.2)μm,P〈0.01]。病理组织学观察及扫描电镜观察显示,ASES和BMS新生内膜覆盖水平及质量均优于SES。(2)支架术后3个月,定量冠状动脉造影显示ASES晚期支架内管腔丢失显著低于BMS[(0.18±0.06)mm比(0.35±0.06)mm,P〈0.05];对OCT图像的分析显示,ASES和SES新生内膜增生百分比均显著低于BMS[(34.75±2.64)%和(35.63±2.07)%比(48.28±3.25)%,均P〈0.01];组织病理学分析显示,ASES和SES面积再狭窄百分比均显著低于BMS组[(28.65±5.64)%和(29.33±6.07)%比(46.18±8.25)%,均P〈0.05]。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2周对再内皮化的抑制作用,同时没有削弱雷帕霉素洗脱支架术后3个?

英文摘要:

[ Abstract] Objective To investigate the impact of the stents coated with sirolimous and anti-CD34 antibody on the short-term re-endothelialization and the long-term restenosis in Chinese Minipigs. Methods Three different types of stents [ bare-metal stent ( BMS ), sirolimous-eluting stent ( SES ) and anti-CD34 antibody and sirolimous-coated stent (ASES)] were randomly implanted in the coronary arteries of 22 Chinese Minipigs. At two weeks after stenting, coronary angiography and optical coherence tomography (OCT) were performed in 10 experimental animals. At three months after stenting, coronary angiography and OCT were performed in the remaining 12 experimental animals. Histopathologic examination was performed on the coronary artery segments containing stent after the animals were executed. Results (1) No in-stent thrombosis and parietal thrombus were found by coronary angiography, OCT and histopathologic examination at two weeks post stenting. OCT analysis showed that the covered ratio of stent struts by neointima in ASES group was higher than in SES group [ ( 55.56 ± 35.27 ) % vs. (41.82 ± 23.28) %, P 〈 0. 05 ]. The mean thickness of neointima in ASES group was significantly higher than in SES group [(89.0±5.0)μm vs. (32.0 ±4.9) μm, P〈0. 01] and BMS group [(89.0 ±5.0) μm vs.(44.0 ± 7.2)μm, P 〈 0. 01 ]. Histopathologic and scanning electron microscopy examinations demonstrated that the covering level and quality of stent struts by neointima in BMS and ASES group were both better than in SES group. (2) At three months follow-up, quantitative coronary angiography analysis found that late in- stent lumen loss in ASES group was significantly lower than in BMS group [ (0. 18 ±0. 06)mm vs. (0. 35 ± 0. 06 ) mm, P 〈 0. 05 ]. OCT analysis showed that the percent neointimal hyperplasia in ASES and SES group was significantly lower than in BMS group [(34.75±2.64)% and (35.63 ±2.07)% vs. (48.28 ± 3.25) %, both P 〈 0. 01 ]. Histop

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期刊信息
  • 《中华心血管病杂志》
  • 中国科技核心期刊
  • 主管单位:中国科学技术协
  • 主办单位:中华医学会
  • 主编:
  • 地址:北京市东四西大街42号
  • 邮编:100710
  • 邮箱:cjc@cma.org.cn
  • 电话:010-85158281
  • 国际标准刊号:ISSN:0253-3758
  • 国内统一刊号:ISSN:11-2148/R
  • 邮发代号:2-44
  • 获奖情况:
  • 中国期刊方阵“双效”期刊,中国科协优秀期刊二等奖,核心期刊及统计源期刊
  • 国内外数据库收录:
  • 美国化学文摘(网络版),荷兰文摘与引文数据库,荷兰医学文摘,美国生物医学检索系统,美国生物科学数据库,日本日本科学技术振兴机构数据库,中国中国科技核心期刊,中国北大核心期刊(2004版),中国北大核心期刊(2008版),中国北大核心期刊(2011版),中国北大核心期刊(2014版),中国北大核心期刊(2000版)
  • 被引量:85641