脑血管支架的生物相容性

Biocompatibility of cerebral intravascular stent

血管支架作为一种异物,置入后刺激血小板在血管支架表面聚集、激活血小板系统及凝血系统,导致血栓的形成。平滑肌细胞向损伤部位迁移发生增殖反应,新生内膜大量增生,血管壁重构引起支架内再狭窄。血管支架置入后发生支架内再狭窄的影响因素不仅取决于支架种类,而且还取决于宿主原有的疾病,此外,血管支架置入前狭窄的严重程度以及支架置入后残留狭窄的长度等都会对再狭窄产生影响。抑制血管内膜过度增生或改善新生内膜形成以及血管重塑过程均可有效防止再狭窄。目前有多种药物也可用于预防再狭窄,主要有抗血小板药、抗炎药生长因子抑制剂和抗细胞增殖药物等。

As a foreign body, intravascular stent will induce platelet aggregation on the stent surface and activate platelet system and coagulation system, resulting in thrombosis. Smooth muscle cells migrate to injured site and proliferate, leading to intimal hyperplasia and vessel wall remodeling, which induces restenosis. Incidence of intravascular restenosis is determined by stent type, disease of the host, severity of stenosis before implantation and remnant stenosis length following stenting. Inhibition of intimal hyperplasia or improvement of intima formation and vessel wall remodeling can effectively prevent restenosis. Currently, there are many drugs to prevent restenosis, including antiplatelet drug, anti-inflammatory growth factor inhibitor and anti-cell proliferation drugs.