摘要
目的探讨纳米t-PA基因载体涂层支架对犬冠状动脉血栓形成和支架再狭窄的影响。方法选取健康雄性家犬22只制作冠状动脉内膜损伤模型后,立即随机分为观察组12只和对照组10只,分别置入载纳米t-PA基因涂层支架和裸金属支架。术后动物均不用抗凝治疗。两组分别于术前及术后1、2、4、8周取血检测t-PA和D-二聚体含量,术后8周行冠状动脉造影和血管内超声检查;超声检查后处死动物,苏木素-伊红染色法染色显微镜下观察局部血管腔内血栓形成、支架内血栓形成和血管壁病理改变。结果两组术前血液t-PA、D-二聚体水平比较差异无统计学意义(P均>0.05);观察组置入支架后1、2、4、8周t-PA、D-二聚体水平均高于对照组(P均<0.05)。支架置入术后8周观察组支架管腔丢失、内膜增生面积、内膜增生容积均优于对照组,两组比较差异均有统计学意义(P均<0.05)。术后8周肉眼及显微镜下观察,对照组支架冠状动脉内膜明显不规则增厚,内膜中增生细胞不规则,排列紊乱,细胞间基质堆积多,见散在炎性细胞。与对照组比较,观察组支架冠状动脉内膜明显变薄,内膜细胞多为长梭形,PCNA阳性细胞少;对照组血栓形成率100%,观察组血栓形成率16.67%,两组血管支架内血栓形成率比较差异有统计学意义(P<0.05)。结论纳米t-PA基因载体涂层支架可有效携带和释放药物,抑制术后冠状动脉支架内再狭窄发生。
Objective To investigate the effect of nano-t-PA gene coating stent on coronary thrombosis and stent restenosis in dogs.Methods Twenty-two healthy male domestic dogs were selected to make the coronary artery intimal injury models,then they were randomly divided into the observation group(12 dogs)and control group(10 dogs).The dogs in the observation group and control group were implanted with nano-t-PA gene coating stent and bare metal stent,respectively.None of the dogs were treated with anticoagulation after intervention.The content of t-PA and D-dimer was measured before operation,1,2,4,and 8 weeks after operation.Coronary angiography and intravascular ultrasound were performed at 8 weeks after operation.Animals were killed after ultrasound examination.Local intravascular thrombosis,stent thrombosis and vascular wall pathological changes were observed under hematoxylin eosin staining microscope.Results There was no significant difference in the levels of t-PA and D-dimer between the two groups(both P>0.05);the levels of t-PA and D-dimer in the observation group were higher than those in the control group(both P<0.05).The loss of stent lumen,the area of endometrial hyperplasia and the volume of endometrial hyperplasia in the observation group were better than those in the control group at 8 weeks after stent implantation,with statistically significant difference between the two groups(all P<0.05).With the naked eye and under the microscope at 8 weeks after intervention,we observed the intima of the coronary artery in the control group was significantly irregularly thickened,the proliferative cells in the intima were irregular,the arrangement was disordered,the intercellular matrix was accumulated,and meanwhile,the scattered inflammatory cells were observed.Compared with the control group,the intima of coronary artery in the observation group was significantly thinner,the intima cells were mostly long fusiform,and the PCNA positive cells were less;the thrombosis rates in the control group and the observation group were 100%and 16.67%,respectively,with a statistical difference between the two groups(P<0.05).Conclusion Nano-t-PA gene carrier coating stent can effectively carry and release drugs,and inhibit the occurrence of restenosis in coronary stent.
作者
李军
章玲
梁新剑
周阳泱
曾碧媚
芦爱霞
赵洪磊
LI Jun;ZHANG Ling;LIANG Xinjian;ZHOU Yangpang;ZENG Bimei;LU Aixia;ZHAO Honglei(Shenzhen People's Hospital,Shenzhen 518000,China;不详)
出处
《山东医药》
CAS
2019年第34期46-48,52,共4页
Shandong Medical Journal
基金
深圳市科技计划项目(JCYJ20180302174003513)
作者简介
通信作者:赵洪磊,E-mail:2867326120@qq.com。
