药物涂层球囊治疗支架内再狭窄的研究进展
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摘要
冠状动脉支架内再狭窄是患者经皮冠状动脉介入治疗后发生主要心血管不良事件(MACE)的原因之一。药物涂层球囊(DCB)的出现和发展,为支架内再狭窄的治疗提供了新的解决思路和方法。目前,球囊表面涂层药物多采用紫杉醇等具有非选择性抑制平滑肌细胞增殖的药物,伴随有急性血栓形成的风险,且载体分子仍需进一步改进。雷帕霉素对损伤后的血管可显著的抑制血管平滑肌细胞和内皮细胞的迁移和增殖继而达到抗血管再狭窄的疗效,雷帕霉素涂层球囊治疗支架内再狭窄具有更广阔的应用前景。中药单体苦参素具有抗平滑肌细胞增殖、抗球囊损伤后再狭窄的作用。姜黄素具有改善血管内皮功能、抗动脉粥样硬化、减少支架内血栓形成的作用。但是苦参素、姜黄素DCB在制作和应用方面仍存在较多问题,两药单独或联合使用能否作为DCB表面涂层药物进而用于支架内再狭窄的治疗,还有待考证。
引文
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[24] 高玉兰,姚永良,俞黎娅,等.姜黄素对脂多糖诱导人脐静脉内皮细胞炎症反应的影响及分子机制[J].海南医学,2017,28(15):2418-2423.
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[29] 任玲,王进,唐家驹,等.含姜黄素的(丙交酯-乙交酯)共聚物薄膜对血管平滑肌细胞增殖的影响[J].生物医学工程学杂志,2008,25(4):874-878.
[30] Bukka M,Rednam PJ,Sinha M.Drug-eluting balloon:design,technology and clinical aspects[J].Biomed Mater,2018,13(3):032001.
[2] Byrne RA,Joner M,Kastrati A.Stent thrombosis and restenosis:what have we learned and where are we going The Andreas Grüntzig Lecture ESC 2014[J].Eur Heart J,2015,36(47):3320-3331.
[3] Sabate M,Raber L,Heg D,et al.Comparison of newer-generation drug-eluting with bare-metal stents in patients with acute ST-segment elevation myocardial infarction:a pooled analysis of the EXAMINATION (clinical Evaluation of the Xience-V stent in Acute Myocardial INfArcTION) and COMFORTABLE-AMI (Comparison of Biolimus Eluted From an Erodible Stent Coating With Bare Metal Stents in Acute ST-Elevation Myocardial Infarction) trials[J].JACC Cardiovasc Interv,2014,7(1):55-63.
[4] Serruys PW,Chevalier B,Sotomi Y,et al.Comparison of an everolimus-eluting bioresorbable scaffold with an everolimus-eluting metallic stent for the treatment of coronary artery stenosis (ABSORB II):a 3 year,randomised,controlled,single-blind,multicentre clinical trial[J].Lancet,2016,388(10059):2479-2491.
[5] Chevalier B,Cequier A,Dudek D,et al.Four-year follow-up of the randomised comparison between an everolimus-eluting bioresorbable scaffold and an everolimus-eluting metallic stent for the treatment of coronary artery stenosis (ABSORB II Trial)[J].EuroIntervention,2018,13(13):1561-1564.
[6] Kereiakes DJ,Ellis SG,Metzger C,et al.3-year clinical outcomes with everolimus-eluting bioresorbable coronary scaffolds:the ABSORB III trial[J].J Am Coll Cardiol,2017,70(23):2852-2862.
[7] Alraies MC,Darmoch F,Tummala R,et al.Diagnosis and management challenges of in-stent restenosis in coronary arteries[J].World J Cardiol,2017,9(8):640-651.
[8] Alfonso F,Scheller B.State of the art:balloon catheter technologies-drug-coated balloon[J].EuroIntervention,2017,13(6):680-695.
[9] Ng VG,Mena C,Pietras C,et al.Local delivery of paclitaxel in the treatment of peripheral arterial disease[J].Eur J Clin Invest,2015,45:333-345.
[10] Xu B,Qian J,Ge J,et al.Two-year results and subgroup analyses of the PEPCAD China in-stent restenosis trial:A prospective,multicenter,randomized trial for the treatment of drug-eluting stent in-stent restenosis[J].Catheter Cardiovasc Interv,2016,87(Suppl 1):624-629.
[11] Kufner S,Cassese S,Valeskini M,et al.Long-term efficacy and safety of paclitaxel-eluting balloon for the treatment of drug-eluting stent restenosis:3-year results of a randomized controlled trial[J].JACC Cardiovasc Interv,2015,8(7):877-884.
[12] Meneguz-Moreno RA,Ribamar Costa J Jr,Abizaid A.Drug-coated balloons:hope or hot air:update on the role of coronary DCB[J].Curr Cardiol Rep,2018,20(10):100.
[13] Axel DI,Kunert W,Goggelmann C,et al.Paclitaxel inhibits arterial smooth muscle cell proliferation and migration in vitro and in vivo using local drug delivery[J].Circulation,1997,96(2):636-645.
[14] Scheller B,Speck U,Romeike B,et al.Contrast media as carriers for local drug delivery.Successful inhibition of neointimal proliferation in the porcine coronary stent model[J].Eur Heart J,2003,24(15):1462-1467.
[15] Scheller B,Speck U,Schmitt A,et al.Addition of paclitaxel to contrast media prevents restenosis after coronary stent implantation[J].J Am Coll Cardiol,2003,42(8):1415-1420.
[16] Unverdorben M,Vallbracht C,Cremers B,et al.Paclitaxel-coated balloon catheter versus paclitaxel-coated stent for the treatment of coronary in-stent restenosis:the three-year results of the PEPCAD II ISR study[J].EuroIntervention,2015,11(8):926-934.
[17] Byrne RA,Neumann FJ,Mehilli J,et al.Paclitaxel-eluting balloons,paclitaxel-eluting stents,and balloon angioplasty in patients with restenosis after implantation of a drug-eluting stent (ISAR-DESIRE 3):a randomised,open-label trial[J].Lancet,2013,381(9865):461-467.
[18] Xu B,Qian J,Ge J,et al.Two-year results and subgroup analyses of the PEPCAD China in-stent restenosis trial:A prospective,multicenter,randomized trial for the treatment of drug-eluting stent in-stent restenosis[J].Catheter Cardiovasc Interv,2016,87(Suppl 1):624-629.
[19] Turner E,Erwin M,Atigh M,et al.In vitro and in vivo assessment of keratose as a novel excipient of paclitaxel coated balloons[J].Front Pharmacol,2018,9:808.
[20] Ali RM,Mask AK,Wan AWA,et al.Treatment of Coronary Drug-Eluting Stent Restenosis by a Sirolimus- or Paclitaxel-coated Balloon[J].JACC Cardiovasc Interv,2019,12(6):558-566.
[21] 史艳平,陈涛,李丹,等.氧化苦参碱药理作用研究进展[J].陕西医学杂志,2018,47(2):271-273.
[22] 杨雪梅,吴刚.苦参碱抑制LPS诱导巨噬细胞IL-1β、TNF-α分泌及机制研究[J].中国免疫学杂志,2016,32(6):820-824,837.
[23] 赵文红.以血管平滑肌细胞为靶标的抗动脉粥样硬化功效成分筛选及其作用机制初探[D].南昌:南昌大学,2011.
[24] 高玉兰,姚永良,俞黎娅,等.姜黄素对脂多糖诱导人脐静脉内皮细胞炎症反应的影响及分子机制[J].海南医学,2017,28(15):2418-2423.
[25] Karimian MS,Matteo P,Johnston TP,et al.Curcumin and endothelial function:evidence and mechanisms of protective effects[J].Curr Pharm Des,2017,23:2462-2473.
[26] Chen X,Zou LQ,Niu J,et al.The stability,sustained release and cellular antioxidant activity of curcumin nanoliposomes[J].Molecules,2015,20(8):14293-14311.
[27] Chen FY,Zhou J,Guo N,et al.Curcumin retunes cholesterol transport homeostasis and inflammation response in M1 macrophage to prevent atherosclerosis[J].Biochem Biophys Res Commun,2015,467(4):872-878.
[28] Han J,Pan XY,Xu Y,et al.Curcumin induces autophagy to protect vascular endothelial cell survival from oxidative stress damage[J].Autophagy,2012,8(5):812-825.
[29] 任玲,王进,唐家驹,等.含姜黄素的(丙交酯-乙交酯)共聚物薄膜对血管平滑肌细胞增殖的影响[J].生物医学工程学杂志,2008,25(4):874-878.
[30] Bukka M,Rednam PJ,Sinha M.Drug-eluting balloon:design,technology and clinical aspects[J].Biomed Mater,2018,13(3):032001.