结合力生长因子在全降解聚合物血管支架力学微环境变化中的作用

The Role of Mechano Growth Factor in Mechanical Microenvironmental Changes After Implantation of Fully Bioresorbable Polymer Scaffolds

动脉粥样硬化作为一种主要的心血管疾病,威胁着全世界人类的健康.全降解聚合物血管内支架是由生物可降解的高分子聚合物材料制作的、用于治疗动脉粥样硬化病变狭窄管腔的植入器械.它克服了金属药物洗脱支架引起的慢性局部炎症反应、血管生理舒缩功能缺失和晚期支架内血栓形成以及未来可能在同一位置再次植入支架的缺陷.但全降解聚合物支架由于各级降解产物的刺激引起炎症反应以及支架植入部位力学微环境的变化,从而引起支架内再狭窄和血栓形成,结合力生长因子(mechano growth factor,MGF)具有对力学刺激敏感的特性,可能对心血管支架植入引起的局部力学变化作出响应.本文对全降解聚合物支架植入后支架的降解特性与力学微环境变化引起的再狭窄、血栓形成等不良反应,以及MGF在其中的作用和研究进展进行综述,以期为临床冠脉介入支架治疗提供参考.

Atherosclerosis,as a major cardiovascular disease,threatens the health of humans worldwide.Currently,drug-eluting stent implantation is the most effective treatment to enlarge the lumen of an artery narrowed by an atherosclerotic lesion.However,drug-eluting stent implantation has several disadvantages,including the late stent thrombosis,neo-atherosclerosis,and local inflammation caused by the presence of the foreign material.To overcome these limitations,bioresorbable scaffolds have been developed as the temporary scaffolds for blood vessels.Fully bioresorbable polymer intravascular scaffolds are made of biodegradable polymers.At the same time,because of the stimulation of degradation products at all levels and the changes in the mechanical microenvironment of the scaffold implantation site,the full degradable polymer scaffolds can cause the inflammatory response,the in-stent restenosis and thrombosis.We combine mechano growth factor(MGF)with local mechanics changes caused by bioresorbable scaffolds.Therefore,this paper reviews the effect between the degradation characteristics and the mechanical microenvironmental changes of fully polymer bioresorbable scaffolds implantation,as well as the research progress of MGF in cardiovascular diseases,in order to provide references for the clinical intervention of fully bioresorbable polymer scaffolds therapy.