中药单体及提取物涂层冠脉介入器械的研究进展

Research progress in coatings with active compounds and extracts of traditional Chinese medicines for coronary intervention devices

近年来,我国心血管疾病发病率和病死率仍在升高,疾病负担下降的拐点尚未出现。经皮冠状动脉介入(percutaneous coronary intervention,PCI)技术是治疗冠状动脉粥样硬化性心脏病的有效手段,其中药物洗脱支架及药物涂层球囊是目前临床中最常用的2种PCI器械,但仍存在再狭窄及晚期血栓事件的问题。如何在保护内皮细胞活性的同时抑制血管平滑肌细胞增殖,进而既抑制再狭窄又抗血栓形成,是研究的热点及难点。中药单体及提取物尤其是中药单体组合涂层具有多靶点潜力,是对人工合成化合物涂层的重要补充。该文综述了应用于PCI器械药物涂层的中药单体(三氧化二砷、紫杉醇、水蛭素、川芎嗪、大黄素、苦参素、姜黄素等)、中药单体组合(紫杉醇/水蛭素、栀子苷/黄芩苷)、中药提取物(莪术提取物、昆明山海棠提取物),并对其中存在的问题及未来发展进行讨论,以期为研发新的PCI器械提供参考。

In recent years,the incidence and mortality rates of cardiovascular diseases in China have kept rising,with no significant reduction in disease burden observed.Percutaneous coronary intervention(PCI)is an effective approach for treating coronary artery disease.Drug-eluting stents and drug-coated balloons are currently the most common PCI devices used in clinical practice.However,challenges with restenosis and late-stage thrombotic events persist.Inhibiting the proliferation of vascular smooth muscle cells while enhancing endothelial cell activity is crucial for reducing restenosis and preventing thrombosis,and it remains a challenge in research.The active compounds and extracts of traditional Chinese medicine(TCM),particularly the combinations of active compounds in coatings,possess multi-target potential and serve as a supplement to coatings prepared from synthetic compounds.This review elucidates the application of TCM active compounds(such as arsenic trioxide,paclitaxel,hirudin,tetramethylpyrazine,emodin,oxymatrine,and curcumin),combinations of TCM active compounds(paclitaxel/hirudin,geniposide/baicalin),and TCM extracts(such as Curcumae Rhizoma extract and Tripterygium hypoglaucum extract)in the coatings for PCI devices in recent years.Furthermore,this review expounds the current challenges and future prospects in this field,giving insights into the innovation of PCI devices.