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目的 探讨不同剂量二烯丙基三硫化物(diallyl trisulfide,DT)包被支架对犬冠状动脉支架置入术后再狭窄的预防作用。方法 制作蛋白涂层的DT包被支架,其剂量分别为0 μg(对照组)、60 μg(小剂量组)、130μg(中剂量组)和210μg(大剂量组)。11只杂种犬,其左冠状动脉分别置入过大的单纯蛋白包被支架和DT包被支架。术前、术后即刻及术后6个月冠状动脉造影观察动脉狭窄程度;术后6个月取出血管组织,经Elastic-van Gieson染色,进行形态学观察,通过图像分析系统分析测定管腔面积、内弹力板包绕面积,并计算内膜面积和面积狭窄率。结果 各组平均损伤积分相似。大剂量组平均内膜厚度[(0.18±0.03)mm]小于中剂量组[(0.24±0.03)mm,P=0.008]、小剂量组[(0.46±0.05)mm,P<0.001]和对照组[(0.49±0.06)mm,P<0.001];大、中剂量组内膜面积相似[(2.50±0.49)mm2比(2.78±0.78)mm2,P>0.05],但显著小于小剂量组[(4.65±0.58)mm2,P<0.001]和对照组[(4.87±0.80)mm2,P<0.001]。大、中剂量组的面积狭窄率相似[(30.04±5.43)％比(34.25±7.41)％,P>0.05],但显著小于小剂量组[(53.10±1.93)％,P<0.001]和对照组[(54.62±6.82)％,P<0.001]。结论 DT包被支架呈剂量依赖性抑制新生内膜增生,6个月内预防再狭窄疗效明显。
Objective To investigate the preventive effects of diallyl trisulfide (DT) -based stent on restenosis after coronary stent implantation in dogs. Methods Protein-coated DT-coated stents were dosed at 0 μg (control), 60 μg (low dose), 130 μg (middle dose) and 210 μg (high dose) respectively. Eleven hybrid dogs, the left coronary artery were placed too large single protein coated stent and DT coated stent. The degree of arterial stenosis was observed before and immediately after operation and at 6 months after operation. The vascular tissues were removed 6 months after operation. Morphology was observed by Elastic-van Gieson staining. The lumen area was determined by image analysis system , Within the elastic plate wrap area, and calculate the intimal area and stenosis rate. Results The average injury scores of each group were similar. The mean intimal thickness in the high-dose group [(0.18 ± 0.03) mm] was lower than that in the middle dose group [(0.24 ± 0.03) mm, P = 0.008] [(0.49 ± 0.06) mm, P <0.001]. The intima area of large and middle dose groups were similar (2.50 ± 0.49 mm2 vs 2.78 ± 0.78 mm2, P> 0.05) 4.65 ± 0.58) mm2, P <0.001], and control group [(4.87 ± 0.80) mm2, P <0.001]. The stenosis rates of the large and medium dose groups were similar [(30.04 ± 5.43)% vs (34.25 ± 7.41)%, P> 0.05], but significantly smaller than those in the low dose group [(53.10 ± 1.93)%, P <0.001] Group [(54.62 ± 6.82)%, P <0.001]. Conclusion DT-coated stents showed a neointimal hyperplasia in a dose-dependent manner, and the effect of preventing restenosis within 6 months was obvious.