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目的评价不同剂量三氧化二砷(As_2O_3)控释洗脱支架防治犬冠状动脉支架术后再狭窄的安全性及疗效。方法用聚甲基丙烯酸丁酯/纳米二氧化硅-聚乳酸/乙醇酸作为支架涂层,将裸支架、涂层支架、大、中、小剂量 As_2O_3(3.2、2.4、1.6μg/mm~2)洗脱支架随机置入犬冠脉回旋支或前降支(每组6只)。术后4周处死,观察支架血管段组织学变化。结果各组内皮完整,未见明显组织反应。大、中剂量组平均新生内膜厚度[(0.14±0.05)mm比(0.15±0.04)mm,P>0.05],显著小于小剂量组、涂层组、裸支架组[(0.27±0.03)mm、(0.39±0.06)mm、(0.33±0.02)mm,P<0.01];新生内膜面积[(1.09±0.11)mm~2比(1.33±0.10)mm~2,P>0.05],显著小于小剂量组、涂层组、裸支架组[(1.93±0.29)mm~2、(2.44±0.15)mm~2、(2.40±0.32)mm~2,P<0.01];管腔面积狭窄率[(19.54±3.59)%比(22.18±3.3)%,P>0.05],显著小于小剂量组、涂层组、裸支架组[(36.22±5.17)%、(50.39±3.03)%、(46.88±5.85)%,P<0.01];管腔面积[(5.14±0.55)mm~2比(4.97±0.38)mm~2,P>0.05],显著大于小剂量组、涂层组、裸支架组[(3.75±0.39)mm~2、(2.62±0.22)mm~2、(3.10±0.66)mm~3,P<0.01]。小剂量组与涂层组、裸支架组各指标比较差异有统计学意义(P<0.01)。结论 As_2O_3控释洗脱支架安全可行,呈剂量依赖性抑制犬冠脉支架术后内膜增生。
Objective To evaluate the safety and efficacy of different doses of arsenic trioxide (As_2O_3) controlled release eluting stents in the prevention and treatment of coronary artery stenosis after coronary stenting. Methods Poly (butyl methacrylate) / nanosilica - polylactide / glycolic acid was used as the scaffold coating. The bare scaffolds, coated scaffolds and the medium, small and medium doses of As 2 O 3 (3.2,2.4,1.6μg / ) Eluting stent was randomly placed in the canine coronary artery or anterior descending artery (6 in each group). Four weeks after the operation, the histological changes of the vascular segments were observed. Results The endothelium of each group was intact with no obvious tissue reaction. The mean neointimal thickness was significantly lower in the large and medium dose groups (0.14 ± 0.05 mm vs 0.15 ± 0.04 mm, P 0.05), which was significantly lower than that of the low dose group, the coating group and the bare stent group [(0.27 ± 0.03) mm , (0.39 ± 0.06) mm, (0.33 ± 0.02) mm, P <0.01]; neointimal area [(1.09 ± 0.11) mm ~ 2 vs 1.33 ± 0.10 mm ~ 2, P> 0.05] (1.93 ± 0.29) mm ~ 2, (2.44 ± 0.15) mm ~ 2, (2.40 ± 0.32) mm ~ 2, P <0.01] in the low-dose group, (19.54 ± 3.59)% vs (22.18 ± 3.3)%, P> 0.05], which was significantly lower than that of the low dose group, the coating group and the bare stent group [(36.22 ± 5.17)%, (50.39 ± 3.03)%, 5.85)%, P <0.01]. The lumen area was significantly larger than that of the low dose group, the coating group and the bare stent group [(5.14 ± 0.55) mm ~ 2 vs (3.75 ± 0.39) mm ~ 2, (2.62 ± 0.22) mm ~ 2, (3.10 ± 0.66) mm ~ 3, P <0.01]. There were significant differences among the indexes of low dose group, coating group and bare stent group (P <0.01). Conclusion As 2 O 3 controlled-release eluting stent is safe and feasible, and it inhibits intimal hyperplasia after canine coronary stent implantation in a dose-dependent manner.