雷公藤甲素涂层支架在兔髂动脉再狭窄模型中抑制新生内膜增殖的作用

Anti-proliferation effect of triptolide-eluting stent in rabbit models with iliac restenosis

目的研究雷公藤甲素涂层支架抑制血管新生内膜增殖的有效性、量效关系,并研究该支架的安全性。方法采用兔髂动脉再狭窄模型,实验支架分4组,每组10个支架。具体分为裸支架组、西罗莫司(雷帕霉素)涂层支架组,5.6μg和56μg雷公藤甲素涂层支架组。每只兔两侧髂动脉各放一支架,共置入40枚支架。比较支架置入后28天各组的形态测量学、组织病理学及血生化结果。结果5.6μg雷公藤甲素涂层支架内的新生内膜面积与裸支架组相似,但大于西罗莫司支架组。56μg雷公藤甲素涂层支架内的新生内膜面积小于裸支架组,与西罗莫司支架组相似。各组支架两端内膜增生不明显。血生化检查未发现雷公藤甲素涂层支架对受试动物产生明显的毒害作用。结论雷公藤甲素涂层支架能够抑制内膜增殖,其效应具有剂量依赖性。56μg雷公藤甲素涂层支架能抑制内膜增殖且无毒副作用。这些结果提示雷公藤甲素涂层支架在置入后4周内能防止再狭窄。

Objective To investigate the anti-proliferation effect of triptolide-eluting stent, as well as its effectiveress, dose-effect relationship and safety. Methods Experimental stents were divided into 4 groups with 10 stents each, namely bare stent group, sirolimus-coated stent group, 5.6 μg triptolide-coated stent group and 56 μg triptolide-coated stent group. By morphometric and histopathologic analysis,we compared 5.6 μg and 56 μg triptolide-eluting stents with bare metal stents and sirolimus-eluting stents 28 days after stenting in rabbit iliac models of restenosis. Results The neointimal area of 5.6 μg triptolide-eluting stents was similar to that of bare metal stents, but larger than that of sirolimus-eluting stents. The neointimal area of 56 μg triptolide-eluting stents was smaller than that of bare metal stents and 5.6 μg triptolide-eluting stents, but was similar to that of sirolimus-eluting stents. In all the groups, proliferation on both edges of the stents was insignificant. No toxic effect had been found in the experimental animals related to triptolide-eluting stent. Conclusion Triptolide-eluting stents may inhibit neointimal proliferation. The effect of inhibiting neointimal proliferation is dose dependent and with no adverse effect. These results suggest that triptolide-eluting stent can prevent restenosis within four weeks.