摘要
目的 评价雷帕霉素涂层支架、甲氨蝶呤涂层支架以及雷帕霉素和甲氨蝶呤混合涂层支架抑制血管新生内膜的作用和预防支架内再狭窄的有效性。方法 本实验采用随机、双盲试验 ,在2 5头微型猪的冠状动脉前降支或左旋支分别置入支架 1枚 ,其中金属裸支架 8枚、甲氨蝶呤涂层支架(每枚支架药物剂量 2 5 0～ 30 0 μg) 5枚、雷帕霉素涂层支架 (每枚支架药物剂量 6 8～ 96 μg) 7枚、雷帕霉素和甲氨蝶呤混合涂层支架 (每枚支架含雷帕霉素 5 8～ 81μg、甲氨蝶呤 12 0～ 170 μg) 5枚。 2 8d后进行冠状动脉造影随访 ,术后处死动物 ,取出支架血管 ,进行组织学分析。结果 再狭窄率 :对照组为2 5 % ( 2 8) ,甲氨蝶呤组为 80 % ( 4 5 ) ,其余 2组为 0。平均狭窄程度 :对照组为 31%± 2 2 % ,甲氨蝶呤涂层支架组为 6 4 %± 2 5 % (P <0 0 5 ) ,雷帕霉素涂层支架组为 8%± 17% (P <0 0 5 ) ,雷帕霉素和甲氨蝶呤混合涂层支架组为 3%± 4 % (P <0 0 5 )。新生内膜面积 :对照组为 ( 2 18± 1 0 3)mm2 ,甲氨蝶呤涂层支架组为 ( 3 93± 1 4 8)mm2 (P =0 0 6 9) ;雷帕霉素涂层支架组为 ( 0 94± 0 88)mm2 (P <0 0 5 ) ,雷帕霉素和甲氨蝶呤混合涂层支架组为 ( 0 4 7± 0 2 4 )mm2 (P <0 0 5 )。
Objective To determine the efficacy of stent based rapamycin (Rapa) and methotrexate (MTX) alone or in combination of them to reduce in stent neointimal hyperplasia Rapamycin is a potent immunosuppressive agent that inhibits smooth muscle cell (SMC) proliferation by blocking cell cycle progression Methods Stents were coated with PLGA (poly/lactic co glycolic acid) polymer containing 68-96 μg Rapa or 250-300 μg MTX or 58-81 μg Rapa and 120-170 μg MTX respectively Twenty five stents (metal, n =8; MTX, n =5; Rapa, n =7; Rapa and MTX, n =5) were implanted in the coronary arteries of 25 pigs Results After 28 days, the mean neointimal thickness was (2 18±1 03) mm 2 in the bare metal stent group; (0 94±0 88) mm 2 in the Rapa group; (0 47±0 24) mm 2 in the combination Rapa and MTX group, (3 93±1 48) mm 2 in the MTX group Compared with metal group the mean neointimal thickness was significantly decresed in Rapa groups and combined group The in stent restenosis was 25% (2/8) in metal group and 80% (4/5) in MTX group after 28 days, and there was no restenosis in the other two groups Conclusion Stent based delivery of Rapa via PLGA polymer can feasibly and effectively reduce in stent neointimal hyperplasia by inhibiting cellular proliferation However there are no effects to reduce in stent neointimal hyperplasia by MTX eluting stents in this study
出处
《中国介入心脏病学杂志》
2004年第2期99-102,共4页
Chinese Journal of Interventional Cardiology
