比较雷公藤内酯醇与西罗莫司洗脱支架预防再狭窄

Triptolide-eluting stent and sirolimus-eluting stent prevent coronary artery in-stent restenosis

目的比较雷公藤内酯醇洗脱支架与西罗莫司(sirolimus,雷帕霉素)洗脱支架预防冠状动脉支架植入术后再狭窄的作用。方法选用杂种幼猪30只,随机分成裸支架组、雷公藤内酯醇洗脱支架组和西罗莫司洗脱支架组,每组各植入支架10枚。术后28d,进行冠状动脉造影、组织病理检查以及免疫组化检测血管平滑肌细胞中增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)。结果雷公藤内酯醇洗脱支架组与西罗莫司洗脱支架组支架内最小内径相似(P>0.05),均大于裸支架组(P<0.01);雷公藤内酯醇洗脱支架组新生内膜面积与西罗莫司洗脱支架组相似(P>0.05),均小于裸支架组(P<0.01)。雷公藤内酯醇洗脱支架组与西罗莫司洗脱支架组的PCNA阳性细胞数相似(P>0.05),均少于裸支架组(P<0.01)。结论雷公藤内酯醇洗脱支架能抑制平滑肌细胞增殖,其预防冠状动脉支架内再狭窄的作用与西罗莫司洗脱支架相似。

Objectives To compare triptolide-eluting stent with sirolimus-eluting stent on coronary artery instent restenosis. Methods Thirty domestic pigs were randomly divided into bare metal stent group, triptolideeluting stent group and sirolimus-eluting stent group. 28 days later, arteries were compared in angiography, histopathology and immunochemistry assessing the expression of proliferating cell nuclear antigen （PCNA）. Results The in-stent minimal lumen diameter of the triptolide group was similar to that of sirolimus group （P〉 0.05）, both of which were larger than that of control group （P〈0.05）. The neointimal area of triptolide group was similar to that of sirolimus group （P〉 0.05）, both of which were smaller than that of control group （P〈 0.05）. PCNA expression in triptolide group was lower that that of control group （P〈0.05）, but similar to that of sirolimus group（P〉0.05）. Conclusions Triptolide-eluting stent can inhibit smooth muscle cell proliferation and has a similar effect on coronary in-stent restenosis as sirolimus-eluting stent.