药物洗脱支架引起的去内皮化与支架内血栓形成机制的研究新进展

New progress in the study of DES-induced deendothelialization and stent thrombosis

药物洗脱支架(DES)因其显著的低支架再狭窄(ISR)发生率,在动脉粥样硬化性疾病中广泛应用。但是,大量研究发现,置入DES的患者发生支架内血栓形成的风险呈上升趋势。相关研究表明,支架内血栓形成的发生与支架血管内皮损伤紧密相连。损伤的内皮层可引起血小板黏附聚集、支架梁异位或支架内新生动脉粥样硬化形成。因此,本文就DES引起的内皮损伤和支架内血栓形成的具体相关机制以及目前研究的生物可降解支架对防御支架内血栓形成的作用做一简要概述。

Drug eluting stents （DES） have dramatically decreased the rate of in-stent restenosis, which are widely used in patients with atherosclerosis. However, as research continues, increasing evidences have demonstrated that the risk of DES-related stent thrombosis （ST） has tended to increase, which is closely associated with delayed endothelium coverage. Impaired endothelium could induce platelet adhesion and aggregation, incomplete stent apposition, or neoather- osclerosis development. Thus, we will discuss the detailed mechanisms for the DES-related deendothelialization and ST, and the effects of biodegradable stents on vascular endothelium.