摘要
目的探讨紫杉醇是否通过影响早期生长反应因子-1(Egr-1)抑制支架内再狭窄(ISR)。方法随机植入裸金属支架(BMS)和紫杉醇药物涂层支架(PES)于猪冠状动脉前降支或回旋支,1个月后冠状动脉造影分析平均血管直径、晚期血管丢失和径向狭窄,测定支架血管段冠状动脉内膜最大厚度、内膜面积和支架段内血管腔面积以及Egr-1表达。结果①PES组无血管丢失和径向狭窄;②BMS组和PES组内膜均完全覆盖支架,PES组支架段内内膜最大厚度和内膜面积均显著小于BMS组而血管腔面积显著大于BMS组(P<0.05);③正常血管段可见Egr-1 mRNA而无Egr-1蛋白表达,与此相比,BMS组血管段Egr-1 mRNA和蛋白表达均显著增强,而PES组血管段Egr-1 mRNA和蛋白表达显著低于BMS组血管段而高于正常血管段。结论BMS可能通过Egr-1导致ISR发生发展,而PES则可能通过抑制Egr-1表达减轻ISR。
Objective To elucidate whether early growth response factor-1 （Egr-1） mRNA and its protein take part in the proceeding of in-stent restennosis （ISR） and whether paclitaxel eluting stent （PE.S） influences the expression of Egr-1 mRNA and its protein after stent embedding coronary artery of sus scrota domestica. Methods Aecording to the ratio of stent vs artery （diameter 1.1 - 1.2 ： 1.0）, both bare metal stent （BMS） and PES were implanted in the anterion descending coronary or circumflex branch coronary. After 1 month, coronary arteriongraphy was finished, the specimens were drawn, the quantity of coronary artery （QCA） was utilized to measure the average vascular diameter, vascular loss and radial restenosis; eosinophilic staining of specimens to measure the most thickness and area of endarterium and area of vascular lumen embedded by stem; RT-PCR to semi-quantitate Egr-1 mRNA and Western blotting to semi-quantitate Egr-1 protein. Results （1）Compared with BMS group, the average vascular diameter was significantly improved （P〈0.05）, both vascular loss （P〈0.05） and radial restennosis （P〈0.05） were significantly diminished in PES group; （2）The inner membrane wrapped completed stent in both group; both the most thickness （P〈0.05） and area of endarterium （P〈0.05） were significantly improved, and the area of vascular lumen （P〈0.05） were significantly increased in PES group than that in BMS group; （3）There were the expression of Egr-1 mRNA and not Egr-1 protein in normal vascular section; compared with normal vascular section, the expression of Egr-1 mRNA and protein were significantly increased （P〈0.05） in BMS group; however, their expression were significantly decreased in PES group than that in BMS group, which were significantly increased than that in normal vascular section. Conclusion BMS might lead to the development of ISR by Egr-1, PES might decreased ISR by Egr-1.
