摘要
学术背景:最新研究发现,内皮修复延迟可导致支架内血栓形成,目前一种既具有良好的抗再狭窄功效同时又具有血栓不易形成安全性的药物支架是人们研究的目标。目的:综述药物洗脱支架新近的研究进展,以及最新的临床应用试验,同时展望其未来的发展趋势和方向。检索策略:由该论文的研究人员应用计算机检索PUBMED2002-01/2007-04期间相关文献,检索词为"drug eluting stents,percutaneous coronary intervention,coronary disease",并限定文章语言种类为English。同时检索2005-01/2007-06因特网最新的相关国际会议报道。共检索到15篇文献,对资料进行初审,纳入标准:①有关药物支架的最新报道。②药物支架的最新研制进展。③药物支架的最新临床应用进展。排除标准:相关性低及重复性文章。文献评价:共收集到264篇药物洗脱支架研究和应用的文献,纳入42篇,同时纳入5篇相关性和时效性较强的会议报道。资料综合:理想的药物洗脱支架由支架平台,药物载体及药物三者协调构成。随着支架材料学和新型药物的开发,更加有效的支架应用于临床治疗中。最近,大量临床研究数据鼓励临床工作者将其应用于更多的挑战性冠脉病例,如慢性完全闭塞病变,多支血管病变等。然而,部分临床研究的结果使药物支架引起的晚期血栓而造成的支架安全性问题更加受到关注和重视。因此在药物支架的开发和应用中力求做到安全性和有效性的平衡。在新型的药物支架中,可降解支架,促进内皮愈合涂层支架更具发展前景。结论:药物洗脱支架是心脏介入治疗中的重大进展,它给冠心病的治疗带来了很多益处尤其是减少了再狭窄和再次血运重建,但随着对其远期疗效和安全性的重视,药物支架的研制将朝向高效低危发展。
BACKGROUND: Latest researches suggest that delayed endothelial repair in drug-eluting stents may cause thrombosis and coronary occlusion. Therefore, a novel kind of drug stent, which is characterized by satisfactory anti-proliferative action as well as inhibitive effects on thrombosis, needs to be developed. OBJECTIVE: To summarize the recent research progress and clinical applications of drug-eluting stents (DES) and to seek the direction of new developments. RETRIEVE STRATEGY: The retrieve staffs were the research personnel for this paper. A computer-based online search was conducted in PUBMED for English language publications containing the
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第51期10404-10408,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
中国博士后基金(20060390602)
国家自然科学基金(30700318)~~
关键词
冠心病
经皮冠脉介入术
药物洗脱支架
of 'drug eluting stents, percutaneous coronary intervention, coronary disease' from January 2002 to April 2007. Relevant data were also searched in international conference reports on the Internet between January 2005 and June 2007. The number of total retrieved literatures was 15. Inclusion criteria: ① reports about drug stents
② reports on research progress in the field of drug stents
③ reports on the clinical application of drug stents. Exclusion criteria: low relevance and duplicated articles. LITERATURE EVALUATION: There were 264 articles about research and clinical applications of DES. Of those, 42 literatures and 5 conference reports with high relevance and timeliness were included in this report. DATA SYNTHESIS: An ideal DES is comprised of a platform, a drug carrier vehicle and a pharmaceutical compound in harmony with each other. Given the ongoing development of DES materials and drugs, more effective DESs are introduced in the clinical practice. Recently, clinical data on DES encourage the interventional cardiologist to use DES in more challenging coronary lesions, such as chronic total occlusions, complex lesions and multivessel lesions. However, concern that DES may be associated with a risk of late thrombotic events arose, suggesting an imbalance between safety and efficacy of DES. Therefore, novel strategies including bioabsorbable stents, and stents coated with pro-healing agents are promising. CONCLUSION: The development of DES is a breakthrough in interventional cardiology that bring great benefit to patients with coronary disease, especially for restenosis and revascularization. Nevertheless, more endeavour will be necessary to create DES with high efficacy as well as low risk.
