摘要
目的:阐述脑血管支架的治疗进展,评价其与宿主间的生物相容性。方法:由第一作者用计算机检索中国期刊全文数据库(CNKI:1989/2009)和Medlinedatabase(1989/2009)数据库,检索词分别为"脑血管病,支架,治疗"和"cerebrovasculardisease,stent,therapy",语言分别设定为中文和英文。共检索到53篇文章,按纳入和排除标准对文献进行筛选,共纳入22篇文章。分别以脑血管支架的治疗进展,脑血管支架置入的并发症和脑血管支架的生物相容性3方面进行归纳和总结,探讨各类不同支架的生物相容性。结果:脑血管支架主要应用于脑动脉狭窄、脑动脉瘤、静脉窦狭窄或血栓治疗。置入并发症主要有颈动脉窦反应,高灌注综合征,脑血管痉挛、血栓形成、再狭窄等。支架置入前对狭窄部位的充分预扩是防止支架变形和移位的关键。血管支架置入后发生再狭窄的影响因素与支架种类有关。在各种脑血管支架中,金属支架易促进血栓的形成。聚合物支架与血管壁的相容性好于金属支架,可避免后期的内膜增殖。涂层支架可通过特殊涂覆技术包被于金属支架表面,抑制血小板的聚集。药物支架置入体内后,药物能够持续高浓度的释放,药物能够在"靶位"达到有效治疗浓度,能够有效的预防支架内置入后的再狭窄。结论:脑血管支架置入可作为脑血管病的一种重要治疗手段。金属支架的生物相容性较差,聚合物支架、涂层支架和药物支架的生物相容性较好。
OBJECTIVE： To investigate therapeutic progress of cerebral intravascular stent, and to evaluate biocompatibility with host.
METHODS： Articles were collected from CNKI and Medline database with the keywords of ＂cerebrovascular disease, stent, and therapy＂ in both Chinese and English from 1989 to 2009. Among 53 articles, 22 were included according to inclusion and exclusion criteria; while the included articles were summarized in the fields of therapeutic progress of cerebral intravascular stent, complication following cerebral intravascular stent implantation, and biocompatibility of cerebral intravascular stent in order to investigate the biocompatibility of various stents.
RESULTS： Cerebral intravascular stent was mainly used to treat cerebral artery stenosis, cerebral aneurysm, venous sinus stenosis, and thrombus. Complications following cerebral intravascular stent implantation included carotid sinus syndrome, hypertransfusion syndrome, cerebral angiospasm, thrombosis, and restenosis. Pre-enlargement prior to implantation in the stenotic region played an important role in avoiding deformation and displacement of stent. Restenosis correlated to stent types following cerebral intravascular stent implantation. For example, metal stent could promote thrombosis; however, polymer which had an excellent biocompatibility to vessel wall was superior to metal stent, thus it could prevent endomembrane proliferation following implantation. Metal-coated stent could inhibit aggregation of platelet; additionally, drug stent could effectively prevent restenosis via high-concentration drug release for a long term.
CONCLUSION： Cerebral intravascular stent is considered as an ideal tool to treat cerebrovascular disease. Metal stent has a poor compatibility, but polymer stent, coating stent, and drug stent have a good compatibility.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第39期7743-7746,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
