血管内支架材料的性能及其临床应用评价

Performance and clinical application of endovascular stent materials

目的:探讨血管内支架的临床应用范围、材料学性能的评价及支架内再狭窄等问题。方法:作者用计算机检索中国期刊全文数据库(CNKI:1960/2009)和Medline database(1960/2009)数据库,检索词分别为"血管内支架,材料,应用"和"endovascular stent,materials,application",语言分别设定为中文和英文。共检索到67篇文献,按纳入和排除标准对文献进行筛选,共纳入31篇文献。分别以血管内支架的应用范围、支架的材料学研究和血管内支架置入后再狭窄等问题出发进行归纳和总结,探讨血管内支架的临床应用和支架材料性能及存在的问题。结果:血管内支架在冠状动脉粥样硬化性心脏病、颅内动脉瘤、症状性或非症状性的缺血性脑血管病以及周围血管病的治疗中都得到了广泛的应用,已有多种材料类型的血管内支架如金属支架、组织工程血管支架及涂层支架等应用于临床,并取得了显著的疗效,其中涂层支架的组织相容性和血液相容性较其他支架更好。血管内支架的功能日趋完善,在临床应用中愈加广泛,但仍存在着支架内再狭窄及免疫排斥反应等问题。结论:血管内支架在许多心脑血管疾病中广泛应用,并取得显著疗效。涂层支架的生物相溶性较其他支架好。使用生物相容性好的血管内支架或应用普罗布考等药物可降低支架内再狭窄的发生概率。

OBJECTIVE：To investigate clinical application of endovascular stents,to evaluate materials performance,and to study in-stent restenosis.METHODS：A computer-based online search was conducted in CNKI and Medline database with the of ＂endovascular stent,materials,application＂ in both Chinese and English from 1960 to 2009.Among 67 articles,31 references were included according to inclusion and exclusion criteria.All the included references were summarized based on application range of endovascular stent,stent materials,in-stent restenosis so as to investigate clinical application and performance of endovascular stent.RESULTS：Endovascular stent had been widely used to treat coronary atherosclerotic heart disease,intracranial aneurysm,symptomatic or non-symptomatic ischemic cerebrovascular disease,and peripheral angiopathy.Varying endovascular stent materials,such as metal,tissue-engineered,and drug-coating had remarkably therapeutic effect;in particular,biocompatibility and blood compatibility of drug-coating stent were superior to those of others.With the functional development of endovascular stent,more and more stents will be used for clinical therapy;however,restenosis and immunological rejection still remain unsolved.CONCLUSION：Endovascular stent has been widely used to treat varying cardio-cerebrovascular disease.Biocompatibility of drug-coating stent is superior to that of other stent materials.Endovascular stent with a great biocompatibility or Probucol-coating stent may reduce the incidence of restenosis.