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目的观察雷公藤内酯醇涂层支架(triptolide)置入猪冠状动脉后,血管内膜增殖过程中NF-κB、ki67表达的变化,探讨该药物支架对血管内皮的影响。方法将8只猪进行冠状动脉支架置入术,将雷公藤内酯醇涂层支架和裸支架组对照,置入前降支、回旋支、右冠脉近端。术后12周处死动物,采用光镜观察内膜增生情况,扫描电镜观察内皮修复情况,免疫组织化学法检测平滑肌细胞NF-κB、ki67表达。结果术后12周,triptolide组血管内膜增生[(内膜厚度(0.12±0.05)mm]、内膜面积[(1.17±0.25)mm2]明显小于对照组[内膜厚度[(0.35±0.11)mm,P<0.01],内膜面积[(1.81±0.36)mm2,P<0.05];电镜显示血管内膜表面的内皮细胞较对照组分布更紧密,排列更整齐,覆盖更完整;药物组NF-κB、ki67表达量显著低于对照组。结论雷公藤内酯醇涂层支架可抑制猪冠状动脉平滑肌细胞增殖,有效控制局部炎性活动,抑制内膜增殖。
Objective To observe the changes of NF-κB and ki67 during the process of intimal hyperplasia after implantation of triptolide into porcine coronary arteries and investigate the effect of the drug-eluting stent on the vascular endothelium. Methods Eight pigs were treated with coronary stent implantation. The triptolide coated stent and the bare stent group were placed in the anterior descending branch, the circumflex branch and the right coronary artery. Animals were sacrificed at 12 weeks after operation, endometrial hyperplasia was observed with light microscope, endothelium repair was observed by scanning electron microscope, and expression of NF-κB and ki67 in smooth muscle cells was detected by immunohistochemistry. Results The intimal hyperplasia [(intima thickness (0.12 ± 0.05) mm] and intima area [(1.17 ± 0.25) mm2] in triptolide group were significantly less than those in control group [(0.35 ± 0.11) mm, P <0.01], and intimal area [(1.81 ± 0.36) mm2, P <0.05]. Electron microscopy showed that the endothelial cells on the intima of blood vessels were more closely distributed and arranged more neatly, κB and ki67 were significantly lower than that of the control group.Conclusion Triptolide-coated scaffolds can inhibit the proliferation of porcine coronary artery smooth muscle cells, effectively control the local inflammatory activity and inhibit the proliferation of intima.