冠状动脉支架材料类型与置入后的效果评价

Material type and treatment effect of coronary stents implantation

目的:冠状动脉内支架有金属裸支架、药物涂层支架、生物降解支架以及新型支架如放射性血管支架、静脉覆盖支架和基因支架等多种。如何选择适宜的支架,以取得最佳的治疗效果,是目前医学界研究的热点。目的:阐述冠状动脉支架的临床应用进展,并探讨冠状动脉支架置入后的治疗效果。方法:作者以"冠状动脉内支架,金属裸支架,药物涂层支架,生物降解支架,心血管新型支架,凝血系统,炎症反应"为检索词,在中国期刊全文数据通信(CNKI:2002/2010)中,采用电子检索的方式进行文献检索。排除Meta分析及重复性研究,共检索到27篇文献,从冠状动脉支架的种类、研究进展及其生物相容性,冠状动脉支架置入后凝血系统的变化,以及冠状动脉支架置入后炎症反应等方面进行探讨。结果:①不论是金属裸支架、药物涂层支架、生物可降解支架以及新型支架,其支架材料的改进更新均以改善生物相容性和生物力学性能为目标。②心血管支架的生物相容性是一个复杂的连锁过程,血液相容性和组织相容性是评定生物相容性的两项基本内容。③利用有限元分析心血管支架材料的力学特性可为未来支架的优化设计提供有益的帮助。结论:现行的心血管支架尚未完全解决生物相容性问题,理想的心血管支架还有待进一步的深入开发与研究。

OBJECTIVE：Coronary stents include bare metal stents,drug-eluting stents,biodegradable stents and new types of stents such as radioactive stents,vein-covered stents and gene stents.How to choose the appropriate stent to achieve the best therapeutic effect is the medical research focus.OBJECTIVE：To describe the clinical application of coronary stents,and to investigate the treatment effect of coronary stent implantation.METHODS：Using ＂coronary stents,bare metal stents,drug eluting stents,biodegradable stent,cardiovascular new stent,blood coagulation system,inflammatory response＂ in Chinese as the key words,a computer search was performed in Chinese Journal Full-text Database（CNKI：2002/2010）.Meta analysis and reproducible study were excluded.A total of 27 articles were screened out,focusing on the coronary stent types,research progress and their biocompatibility,blood coagulation system changes after implantation of coronary stents,and inflammation reaction after coronary stents implantation.RESULTS：① No matter bare metal stents,drug-eluting stents,biodegradable stents or new stents,the cardiovascular stents are modified in order to improve the biocompatibility and biomechanical properties.② The biocompatibility of cardiovascular stents is a complex process,blood compatibility and tissue compatibility are two basic compositions for the assessment of the biocompatibility.③ The mechanical properties of cardiovascular stents analyzed using finite element analysis can provide useful help for the optimal design.CONCLUSION：The present cardiovascular stents have not completely solved the biocompatible problem,an ideal cardiovascular stent deserves further development and research.