李少君,李宁,李志韬,田野,于波

• 1:哈尔滨医科大学附属二院心内科
• 2:心肌缺血机理与诊疗技术省部共建教育部重点实验室(哈尔滨医科大学)

摘要(Abstract)：

目的探讨猪冠状动脉介入术后内弹力板损伤对术后再狭窄的影响,初步探讨其中可能的机制。方法制作猪冠状动脉介入损伤模型,测量介入术后即刻弹性回缩以及远期内膜增生的程度,分析内弹力板损伤程度与上述指标的关系。结果 30份血管标本均存在不同程度的损伤,平均损伤积分(injury score)为3.08±1.11。血管弹性回缩的平均值为(0.05±0.03)mm,多元回归及曲线拟合结果显示,内弹力板损伤是影响血管弹性回缩量的最重要因素;内弹力板损伤对介入术后远期内膜增生的的影响程度最大,单独存在内弹力板破损的血管段其内膜增生的程度明显高于仅仅有轻度内皮细胞脱落的血管段,其新生内膜面积和厚度分别是后者的2.44倍和2.51倍。结论冠状动脉介入术后内弹力板损伤对再狭窄的影响是关键性的,可能作为预测介入术后再狭窄的一项检测指标。

关键词(KeyWords)： 血管成形术;冠状动脉;血管内膜;冠状动脉再狭窄

Abstract:

Keywords:

基金项目(Foundation): 黑龙江省卫生厅科研课题(2009-169)

作者(Author): 李少君,李宁,李志韬,田野,于波

参考文献(References)：

• [1]Takahashi S,Kaneda H,Tanaka S,et al.Late angiographic stent thrombosis after sirolimus-eluting stent implantation.Circ J,2007,71:226-228.
• [2]Takeda S,Shirasawa K,Hatakeyama Y,et al.Late thrombosis of a drug-eluting stent overlapped in the in-stent restenotic lesion of a bare metal stent.Int J Cardiol,2007,116:e25-26.
• [3]Sick P,Huttl T,Niebauer J,et al.Influence of residual stenosisafter percutaneous coronary intervention with stent implantation on development of restenosis and stent thrombosis.Am J Cardiol,2003,91:148-153.
• [4]Rensing BJ,Hermans WR,Beatt KJ,et al.Quantitative angiographic assessment of elastic recoil after percutaneous transluminal coronary angioplasty.Am J Cardiol,1990,66:1039-1044.
• [5]Sousa JE,Serruys PW,Costa MA.New frontiers in cardiology:drug-eluting stents:Part II.Circulation,2003,107:2383-2389.
• [6]Serruys PW,Degertekin M,Tanabe K,et al.Vascular responses at proximal and distal edges of paclitaxel-eluting stents:serial intravascular ultrasound analysis from the TAXUS II trial.Circulation,2004,109:627-633.
• [7]Farb A,Burke AP,Kolodgie FD,et al.Pathological mechanisms of fatal late coronary stent thrombosis in humans.Circulation,2003,108:1701-1706.
• [8]Ratib K,Doshi SN,Townend JN.Double-stenting of an ostial left main-stem lesion for elastic recoil.Int J Cardiol,2005,102:357-358.
• [9]Albiero R,Silber S,Di Mario C,et al.Cutting balloon versus conventional balloon angioplasty for the treatment of in-stent restenosis:results of the restenosis cutting balloon evaluation trial(RESCUT).J Am Coll Cardiol,2004,43:943-949.
• [10]van Werkum JW,Heestermans AA,Plokker HW,et al.Clinical,biochemical and genetical resistance to clopidogrel in a patient with recurrent stent thrombosis.Int J Cardiol,2007,116:136-137.