摘要
目的探讨小肠黏膜下层(SIS)促进支架表面内皮化在预防经皮血管腔内支架植入术(PTS)后再狭窄的价值。方法 14头猪经颈动脉球囊过度扩张双侧髂动脉后,随机选取一侧髂动脉植入裸支架(bare stent,BS),对侧髂动脉植入SIS覆膜支架(SCS)。于4、8、12周分别对4、5、5头猪进行造影复查,并处死,对支架段标本行病理组织学及扫描电镜观察。结果 14头猪(28支髂动脉)共成功植入14枚BS及14枚SCS支架。复查造影示,8周时SCS组和BS组各有1支动脉闭塞,其余26枚支架均通畅,4、8、12周时SCS组再狭窄率与BS组比较差异均无统计学意义(P<0.05)。免疫组化示4、8、12周时SCS组增殖细胞核抗原阳性细胞平均百分率均明显低于BS组(P<0.05);电镜见SCS组新生内膜内皮细胞数均高于BS组,组间差异有统计学意义(P<0.05)。结论 SIS具有促进内皮细胞再生及支架表面内皮化的作用,可间接抑制血管平滑肌细胞增殖,并促进合成型平滑肌细胞向收缩型转变的作用。
Objective To explore the promotion effect of small intestinal submucosa （SIS） on the endothelial regeneration of vascular stent surface that was percutaneously-inserted in experimental swine, and to discuss its clinical value in preventing restenosis of the stent. Methods Fourteen domestic swine were used for this study. Via the carotid access the bilateral iliac arterial catheterization was performed in all animals. After excessive balloon dilatation of bilateral iliac arteries, bare stent （BS） was implanted in randomly-selected one iliac artery, while SIS-eluting stent was placed in the iliae artery on the opposite side. The animals were separately re-examined with angiography at 4 weeks （n = 4）, 8 weeks （n = 5） and 12 weeks （n = 5） after the treatment. After the angiography the animals were sacrificed. The specimens carrying stent were collected and sent for histopathological and electron-microscopic studies. The results were analyzed and compared between the SIS- eluting stent group and the BS group. Results Implantation of 14 SIS- eluting stents and 14 BS stents was successfully accomplished in 28 iliac arteries of the 14 pigs. Follow-up angiography showed that one iliae artery was occluded in both SIS- eluting stent group and BS group at 8 weeks after the treatment, and all the remaining 26 stents were patent. At 4, 8 and 12 weeks after the treatment, no statistically significant difference in restenosis rate existed between the SIS-eluting stent group and the BS group （P 〉 0.05）. Immunohistochemistry study revealed that mean percentage of the cells with positive proliferating cell nuclear antigen （PCNA） of the SIS-eluting stent group at 4, 8 and 12 weeks afterthe treatment was significantly lower than that of the BS group （P 〈 0.05）. Electron-microscopic study revealed that the number of intimal endothelial cells of the SIS- eluting stent group was significantly larger than that of the BS group（P 〈 0.05 ）. Conclusion SIS does have the function of promoting the regeneration of endothelium as well as speeding up the endothelialization of stent surface. It can indirectly inhibit the proliferation of vessel smooth muscle cells and promote the transformation of synthetic smooth muscle cells to contractive ones. （J lntervent Radiol, 2013, 22 ： 403-408）
出处
《介入放射学杂志》
CSCD
北大核心
2013年第5期403-408,共6页
Journal of Interventional Radiology
关键词
再狭窄
小肠黏膜下层
内皮细胞
经皮血管腔内支架植入术
动物实验
restenosis
small intestinal submucosa
endothelial cell
percutaneous endovescularstent implantation
animal experiment
