摘要
目的:了解抗增殖作用药物涂层支架的种类和特点及其在临床应用中的有效性和亟待解决的问题。方法:作者以"冠状动脉内支架;心血管疾病;细胞增生;药物涂层;再狭窄"为检索词,在中国期刊全文数据库中,采用电子检索的方式进行文献检索。纳入与抗增殖作用药物涂层支架预防血管再狭窄有关的文章。排除Meta分析及重复性研究,共入选16篇文献。结果:经皮冠状动脉腔内成形和支架置入后的最突出问题是血管再狭窄。血栓、炎症和平滑肌增生是支架内再狭窄的3个重要阶段,其中血管内膜增生是再狭窄的最主要机制。目前最常用的抗增生药物为紫杉醇和雷帕霉素及其衍生物。雷帕霉素通过抑制内膜、平滑肌细胞等增生抑制血管内再狭窄发生发展,而紫杉醇通过促进内皮细胞和平滑肌细胞等凋亡抑制血管内再狭窄发生发展。结论:抗增殖药物涂层支架已成为当前最有希望降低再狭窄发生率的手段,但是血管再狭窄是一个多因素的复杂问题,药物涂层支架的研究和应用还处于探索阶段,正确地评价药物涂层支架将有赖于大样本的临床科学试验。
OBJECTIVE：To understand the types and characteristics of anti-proliferative drug-eluting stent,and its effectiveness in clinical applications and problems to be solved.METHODS：Using ＂intracoronary stent;cardiovascular disease;cell proliferation;drug-eluting;restenosis＂ as the Chinese key words,Chinese Academic Journal Full-text database was retrieved.Articles related to anti-proliferative drug-eluting stents to prevent restenosis were included.Meta analysis and reproduced study were excluded,a total of 16 literatures were selected.RESULTS：Restenosis is the most obvious problem after percutaneous transluminal coronary angioplasty and stenting.Thrombosis,inflammation and smooth muscle hyperplasia are three major stages of in-stent restenosis,intimal hyperplasia is the most important mechanism of restenosis.The most commonly used anti-proliferative drugs are paclitaxel and rapamycin,and their derivatives.Rapamycin depresses restenosis occurrence and development by inhibiting intima and vascular smooth muscle cell proliferation,while paclitaxel by promoting endothelial cells and smooth muscle cell apoptosis.CONCLUSION：Anti-proliferative drug-eluting stents have become the most potential approach to reduce the incidence of restenosis,but the restenosis is a complicated problem with several factors,drug-eluting stents study and application are still at the exploration stage,correct evaluation of drug-eluting stent will depend on a large sample of clinical scientific experiments.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第34期6405-6408,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
