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冠状动脉内支架植入术已经是目前应用最广泛的冠心病介入治疗技术,虽然与单纯的经皮腔内冠状动脉成形术(PTCA)相比较,支架植入术后的再狭窄率已大大降低,在局限性病变和直径>3.0mm血管的病变中,支架内再狭窄(in-stentrestenosis,ISR)的发生率大约是10%~20%,如果合并有糖尿病等危险因素,弥漫性病变或是直径<3.0mm血管的病变,则ISR的发生率高达30%~60%,所以如何降低冠状动脉内支架植入术后的再狭窄率,是一个迫切需要解决的问题。 再狭窄的发生机制主要有:①血管弹性回缩;②血管重建;③血管内皮增生。支架植入术可以防止血管弹性回缩和血管重建所引起的再狭窄的发生,但却加剧了血管内皮的增生。这是因为支架植入引起了血管损伤及排异反应,从而启动了血管壁
Coronary stenting has been the most widely used technique for interventional therapy of coronary artery disease. Although the rate of restenosis after stent implantation has been greatly reduced compared with pure percutaneous transluminal coronary angioplasty (PTCA) , The incidence of in-stent restenosis (ISR) is about 10% to 20% in the case of localized lesions and lesions of> 3.0 mm in diameter. If combined with risk factors such as diabetes, diffuse lesions or Therefore, how to reduce the rate of restenosis after coronary stent implantation is an urgent problem to be solved. The main mechanism of restenosis are: ① elastic recovery of blood vessels; ② vascular reconstruction; ③ vascular endothelial proliferation. Stent implantation can prevent the occurrence of restenosis caused by the elastic retraction and revascularization of blood vessels, but exacerbate the proliferation of vascular endothelial cells. This is because stent implantation causes vascular damage and rejection, which initiates the vessel wall