DHDCS抑制小型猪外周动脉管腔丢失及内膜增生的研究

Study on inhibition of lumen reduction in peripheral artery and neointimal hyperplasia with a novel dexamethasone-heparin-double coated stent using zein as carrier in porcine

目的研究玉米醇蛋白载体地塞米松-肝素双涂层支架(DHDCS)抑制小型猪外周动脉管腔丢失及内膜增生的有效性和安全性。方法 24只小型猪平均分为4组,每组6只,每只动物选用髂内动脉、髂外动脉、骶尾动脉及股动脉4支血管,分别植入金属裸支架(bare mental stent,BMS)、玉米醇蛋白涂层支架(protein coated stent,PCS)、肝素微球涂层支架(heparin microballoons coated stent,HMCS)和DHDCS。每组取3只动物,分为支架植入30 d组和90 d组,分别复查远端腹主动脉造影,评价管腔丢失;并处死动物,取支架处动脉血管,塑料包埋硬组织切片,进行伊红染色(HE染色)和扫描电镜检查,分析其组织学形态。每组术前后比较采用配对样本t检验,组间比较采用单因素方差分析方法进行统计学分析。结果 DHDCS组动脉管腔丢失及内膜平均厚度明显小于蛋白涂层支架组、肝素微球涂层支架组和裸支架组(P<0.05),差异有统计学意义。结论 DHDCS能够安全有效地降低小型猪外周动脉管腔丢失及减轻支架内血管内膜增生,可以预防支架内管腔再狭窄。

Objective To evaluate the efficacy and safety of dexamethasone-heparin-double coated stent（DHDCS） using zein as carrier for inhibition of lumen reduction in peripheral artery and neointimal hyperplasia in porcine model.Methods Bare metal stent（BMS,n=24）,zein protein coated stent（PCS,n=24）,heparin microballoon coated stent（HMCS,n = 24） and DHDCS（n=24） were implanted into selected arteries of internal iliac artery,external iliac artery,sacrococcygeal artery and femoral artery in each of 4 groups of porcine（n=24） on average.All these 24 pigs were divided into two groups including three animals from each of four groups by time.Distal abdominal aortography had been performed to evaluate the reduction of arterial lumen 30 and 90 days after the implantation.Subsequently,all pigs were killed and their arteries with the stents inside were taken out,they were embedded in plastic for hard histological section and hematoxylin-eosin（H.E.） staining,then they were examined by light microscopy and scanning electron microscopy for analysis of their histological appearance.Paired-Samples T Test and One-Way ANOVA analysis were used for statistical analysis with SPSS 11.0.Results The reduction of arterial lumen and average neointimal hyperplasia in group of DHDCS were obviously less than those in groups of BMS,PCS and HMCS.Conclusion DHDCS can decrease the reduction of lumen of periphery artery and neointimal hyperplasia and it may effectively and safely prevent restenosis of stent.