雌激素洗脱支架植入兔腹主动脉对内膜增生及内皮化的影响
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Effects of 17β-Estradiol Eluting Stent Implantation on Neointima Proliferation and Re-Endothelialization of Abdominal Aorta in Rabbits
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    目的评价雌激素洗脱支架对在体兔腹主动脉内膜增生及内皮化的影响。方法雄兔高脂喂养制成高脂血症模型后分三组,分别于腹主动脉植入裸金属支架、磷酸胆碱涂层支架和17β雌二醇洗脱支架,前两种支架作为对照。每组18只,各组于术后2、4及12周取出6只兔的支架段腹主动脉,测算支架处血管腔面积、新生内膜厚度和面积及管腔狭窄百分比以评价内膜增生程度。应用免疫组织化学染色法分析各时相支架段血管内膜Ⅷ因子阳性率以评估其再内皮化程度。结果3组不同支架植入后导致的血管损伤积分在各时相基本相同(2.17±0.22、2.18±0.21和2.17±0.19,p>0.05);各组支架植入2周时血管内膜已经增厚,在12周时管腔狭窄均<50%,但12周时雌二醇洗脱支架组新生内膜面积较裸金属支架组减少36%(p<0.01),磷酸胆碱涂层支架组与裸金属支架组相比无明显差别;2周与12周时新生内膜面积比在雌二醇洗脱支架组、磷酸胆碱涂层支架组、裸金属支架组分别为0.77、0.61和0.61(p<0.01)。2周时雌二醇洗脱支架组内皮化率明显高于裸金属支架组及磷酸胆碱涂层支架组(78.4%±2.3%比61.4%±3.4%及62.8%±2.9%,p<0.01),4周时各组血管内膜均接近完全内皮化。结论雌二醇洗脱支架可明显减少血管内支架植入后的内膜增生,加速支架段血管的再内皮化,具有良好的对抗再狭窄的应用前景。

    Abstract:

    Aim To investigate the effect of 17β-estradiol(17β-E2) eluting stent implantation on neointima proliferation and re-endothelialization of abdominal aorta in rabbits. Methods Male rabbits were divided into 3 groups after hyperlipemia feed.17β-E2 eluting stents,phosphorylcholine(PC) coated metal stents and bare metal stents were implanted in each groups.The stented aortas tissue of 6 rabbits were removed at 2 weeks,4 weeks and 12 weeks from each group respectively.Lumen area,thickness and area of neointima at different time after stent implantation were measured by computer image analysis technique.Immunohistochemistry was used to detect the positive rate of factor Ⅷ expression of the arterial intima at different time in order to assess re-endothelialization degree. Results The mean injury scores were similar in three groups(2.17±0.22,(2.18)±0.21 and 2.17±0.19,p>0.05).The neointima areas had increased at 2 weeks after stent implantation,and the lumen loss rates were less than 50% at 12 weeks in three groups.At 12 weeks neointima area reduced 36% in 17β-E2 eluting stent group compared with that of bare metal stent group,and had no difference between PC coated and bare metal stent groups.The ratio of neointima area at the time of 2 week and 12 week was compared within each group,and the results showed that the 17β-E2 group had significantly higher ratio than other two groups(0.77,0.61 and 0.61,respectively,p<0.01).At the time of 2 week the re-endothelialization rate in 17β-E2 eluting stent group was obviously higher than PC coated stent and bare metal stent groups((78.4%)±2.3% vs 61.4%±3.4% and 62.8%±2.9%,p<0.01),and nearly complete re-endothelialization were found at 4 weeks after stent implantation procedure in three groups. Conclusions 17β-E2 eluting stent has ideal effect in preventing restenosis by inhibition of neointima proliferation as well as acceleration of re-endothelialization of treated arteries.

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韩雅玲,梁明,康建,齐岩梅.雌激素洗脱支架植入兔腹主动脉对内膜增生及内皮化的影响[J].中国动脉硬化杂志,2005,13(6):729~733.

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  • 收稿日期:2005-01-11
  • 最后修改日期:2005-11-16
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