小口径组织工程血管支架:如何产生一种具有生理重塑活性的材料

Small-caliber tissue-engineered vascular stent:how to produce a material with physiological remodeling activity

背景:心血管疾病目前临床上常用的治疗方法是血管重建术,包括经支架介入治疗、冠状动脉旁路移植术和血管成形术。目的:总结天然衍生支架材料、人工合成高分子材料和复合材料等组织工程血管支架材料的最新研究进展,为小口径血管置换提供理论依据。方法:检索PubMed数据库、万方数据库和中国全文期刊数据库2008年1月至2019年7月相关文献,以检索词为"组织工程;生物材料;支架材料;血管""Tissue engineering,biological material,scaffold material,blood vessel"进行中英文检索。排除内容较陈旧及结论重复性文献,对最终入选的52篇文献进行探讨。结果与结论:自体血管移植物,如隐静脉和胸内动脉,是小口径血管的最佳替代物,然而在移植后可能诱发血管腔再次狭窄,以及导致血栓形成、感染和移植失败发生率增加,因而严重阻碍在临床上的应用。考虑到存在的这些局限性,研究者将组织工程血管移植物嵌入细胞,从而产生一种具有生理重塑活材料,这一潜在的解决方案可为血管移植物的未来带来希望。

BACKGROUND:The common clinical treatment methods of cardiovascular disease are vascular reconstruction,including stent interventional therapy,coronary artery bypass grafting and angioplasty.OBJECTIVE:To summarize the latest research progress of tissue-engineered vascular stent materials,such as natural derivative stent materials,synthetic macromolecule materials and composite materials,so as to lay a theoretical foundation for small-caliber vascular transplantation.METHODS:Pub Med,Wan Fang,and CNI databases were retrieved for the articles published from January 2008 to July 2019.The key words were"tissue engineering,biological material,scaffold material,blood vessel"in Chinese and English,respectively.The documents with old content and repeated conclusions were excluded,and 52 eligible articles were enrolled.RESULTS AND CONCLUSION:Autologous vascular grafts,such as saphenous vein and internal thoracic artery,are the best alternatives to small-caliber vessels.However,restenosis of vascular lumen may be induced after transplantation,and the incidence of thrombosis,infection and transplantation failure increases,which seriously hinders the clinical application.Considering these limitations,researchers have embedded tissue-engineered vascular grafts into cells to produce a living material with physiological remodeling activity.This potential solution may bring hope for the future of vascular grafts.