雷帕霉素药物洗脱支架对糖尿病小型猪冠状动脉支架置入后内膜增生的影响

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目的:评估雷帕霉素药物洗脱支架(SES)对糖尿病小型猪冠状动脉支架置入后内膜增生的作用。方法:建立链脲菌素诱导的糖尿病小型猪模型(糖尿病组,n=12),随机选取2支冠状动脉置入SES,共计置入24枚支架,术后饲养6个月,与非糖尿病置入SES支架的小型猪模型(对照组,n=12)比较冠状动脉造影、血管内超声及组织切片检查结果。结果:两组动物支架置入冠状动脉分布,术前参照血管直径[糖尿病组:(2.78±0.35)mm,对照组:(2.81±0.29)mm]及术后即刻最小管腔内径[糖尿病组:(2.90±0.42)mm,对照组:(2.89±0.33)mm]均相似(P均>0.05)。术后6个月糖尿病组支架内狭窄程度[(35.6±9.2)%和(7.9±3.1)%,P<0.001]、支架内晚期管腔丢失[(0.32±0.09)mm和(0.09±0.04)mm,P<0.001]、新生内膜厚度[血管内超声:(0.35±0.12)mm和(0.11±0.08)mm,P<0.05]及新生内膜面积[血管内超声:(1.29±0.51)mm2和(0.26±0.11)mm2,P<0.001;组织切片:(1.24±0.76)mm2和(0.19±0.08)mm2,P<0.05]均显著高于对照组。结论:糖尿病小型猪冠状动脉置入SES后内膜增生程度显著高于无糖尿病模型。 Objective: To evaluate the effect of rapamycin-eluting stent (SES) on neointimal hyperplasia after implantation of diabetic mini-swine coronary stents. Methods: Streptozotocin-induced diabetic miniature pig model (diabetic group, n = 12) was established. Two coronary arteries were randomly selected and placed in SES. A total of 24 stents were housed and were maintained for 6 months postoperatively. Mini-swine models into the SES scaffold (control group, n = 12) compared coronary angiography, intravascular ultrasound and histological examination. Results: The coronary stents were placed in two groups of animals, and the preoperative reference was made to the diameter of the blood vessels (2.78 ± 0.35 mm in the diabetes group and 2.81 ± 0.29 mm in the control group) and the smallest lumen diameter immediately after the operation [Diabetes group: (2.90 ± 0.42) mm in the control group: (2.89 ± 0.33) mm] (all P> 0.05). The degree of stent stenosis was significantly higher in patients with diabetes mellitus at 6 months after surgery (35.6 ± 9.2% vs 7.9 ± 3.1%, P <0.001), and the late stent loss was (0.32 ± 0.09) mm and (0.09 ± 0.04) mm, P <0.001], neointimal thickness [intravascular ultrasound: (0.35 ± 0.12) mm and (0.11 ± 0.08) mm, P <0.05] and neointimal area [intravascular ultrasound: (1.29 ± 0.51) mm2 And (0.26 ± 0.11) mm2, P <0.001. Tissue sections: (1.24 ± 0.76) mm2 and (0.19 ± 0.08) mm2, P <0.05] were significantly higher than those in the control group. Conclusion: Intimal hyperplasia was significantly higher in diabetic miniature pigs than in non-diabetic coronary arteries after SES implantation.
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