脑血管支架种类及材料学特点与支架置入后的补体反应

Types and material characteristics of cerebral vascular stent and complement reaction after stenting

目的:探讨脑血管支架材料学特点及补体反应与支架置入后并发症的关系。方法:以"脑血管支架,生物材料,生物相容性,再狭窄,补体反应"为中文检索词;以"rebrovascular disease,stent,therapy,complement"为英文检索词,采用计算机检索Pubmed数据库(http://www.ncbi.nlm.nih.gov/PubMed)及维普数据库(http://www.cqvip.com/)2000-01/2008-12有关脑血管支架材料学特点与支架置入后补体反应的文章;排除重复研究及Meta分析类文章。以24篇文献为主重点探讨了脑血管支架材料学特点及补体反应与支架置入后并发症的关系。结果:金属支架的生物相容性较差,聚合物支架、涂层支架和药物支架的生物相容性较好。脑血管支架作为治疗颅内外血管性疾病的一个重要手段,可降低颅内外动脉狭窄患者缺血性脑卒中的风险,但支架置入后的并发症如再狭窄等问题严重阻碍着该技术的进一步发展,免疫炎症反应在缺血性脑损伤机制中起着重要作用,生物材料对补体系统也有明显的影响。结论:选用合适的生物医用材料,脑血管支架置入治疗可明显降低脑血管病的死亡率。但要注意脑血管支架置入过程中以及置入后可能发生的并发症,给予积极的防治是非常重要的。研制新的生物医用材料,同时检测补体系统相关指标,将会提高脑血管支架置入治疗的成功率。

OBJECTIVE：To explore the material characteristics of cerebral vascular stents,and the correlation between complement reactions and complications after stenting.METHODS：Using＂cerebral vascular stents,biomaterials,biocompatibility,restenosis,complement reaction＂as the Chinese key words,＂rebrovascular disease,stent,therapy,complement＂as the English key words,a computer search was conducted on Pubmed database（http：//www.ncbi.nlm.nih.gov/PubMed）and the VIP database（http：//www.cqvip.com/）from January 2000 to December 2008 for articles about the characteristics of cerebral vascular stents and complement reaction after stent implantation;repeated study and Meta analysis articles were excluded.Totally 24 articles mainly focus on the material science characteristics of cerebral vascular stent and the correlation between complement reactions and complications after stenting.RESULTS：The metallic stents have poor biocompatibility while polymer stents,coated stents and drug stents are present with better biocompatibility.Cerebral vascular stents,as an important means of the treatment of intracranial and extracranial vascular disease,it can reduce ischemic stroke risk in patients with intracranial and extracranial artery stenosis,but the complications after stenting such as restenosis,may seriously impede further development of the technology,immune inflammatory response play an important role in ischemic brain injury mechanisms and the biomaterials also has significant impact on the complement system.CONCLUSION：Using the appropriate biomedical materials,cerebrovascular stent placement can significantly reduce the mortality rate of cerebrovascular disease.But the complications occur during and after the process of vascular stent placement,should be paid attention and given positive control measures.Development of new biomedical materials,and simultaneous detection of the complement system-related indicators,will increase the success rate of cerebral vascular stent.