冠状动脉旁路移植术后静脉桥血管再狭窄的机制研究进展

Advance in mechanisms of vein graft restenosis after coronary bypass grafting

冠状动脉旁路移植术是治疗冠心病最有效的方法,其中大隐静脉是静脉桥血管的首选。但静脉桥血管10年再狭窄率超过60%,严重影响患者的预后和远期生存率。静脉桥血管再狭窄是多因素、多环节共同作用的结果,包括早期的内皮损伤、血栓形成、再内皮化、静脉桥血管的动脉化,中期的内膜增生以及晚期的粥样硬化及斑块破裂等。本文综述了静脉桥血管再狭窄机制的最新研究进展,并对未来预防静脉桥血管再狭窄的方法进行展望。

Coronary bypass grafting （CBG） is the most effective method of treating coronary artery disease and venae saphena magna is commonly used as vein graft for surgical revascularization; however, the incidence of vein graft restenosis is more than 60% in ten years after CBG, which threatens the prognosis and long-term survival of the patients. The vein graft restenosis has multiple factors and levels, including de-endothelialization, thrombosis, re-endothelialization and arterialization of vein graft in the early stage, intimal hyperplasia in the middle stage, and atherosclerosis and plaque rupture in the late stage. This review summarized the latest researches of the mechanisms of vein graft restenosis after coronary bypass grafting and discussed the prevention methods.