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经皮腔内冠状动脉形成术(PTCA)作为治疗冠心病的有效手段,已被广泛应用。但其急性血管闭塞及术后血管再狭窄却在一定程度上限制了PTCA的发展。最近十年冠脉内支架的置入,获得了令人鼓舞的效果。研究表明,冠脉内支架可显著降低冠脉介入治疗时急性缺血并发症,而对于血管再狭窄,虽然支架术后血管管腔的扩大明显优于PTCA,血管再狭窄发生率低于PTCA,但支架对血管壁的损伤、异物的炎性反应、支架对血管长期牵拉作用可导致血管内膜增生,引起血管再狭窄。这也是冠心病介入治疗的难题及研究的热点。本文主要就冠脉内支架术后再狭窄的机制、再狭窄的预防及治疗作一综述。
Percutaneous transluminal coronary angioplasty (PTCA) as an effective treatment of coronary heart disease has been widely used. However, its acute vascular occlusion and postoperative vascular restenosis to a certain extent, limited the development of PTCA. The placement of coronary stents in the last decade has yielded encouraging results. Studies have shown that coronary stent can significantly reduce the acute ischemic complications of coronary intervention, while for vascular restenosis, although the expansion of the vessel lumen was significantly better than PTCA after stent, the incidence of vascular restenosis was lower than that of PTCA, But stent damage to the vessel wall, foreign body inflammatory reaction, stent long-term vascular pull can lead to vascular intimal hyperplasia, causing vascular restenosis. This is also the problem of coronary intervention and research hot spots. This article mainly reviews the mechanism of restenosis after coronary stent and the prevention and treatment of restenosis.