中国组织工程研究

中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (18): 2864-2869.doi: 10.3969/j.issn.2095-4344.2017.18.013

• 材料生物相容性 material biocompatibility • 上一篇    下一篇

镁合金支架在兔腹主动脉中的降解

安  乾，崔文军，司江涛，王  颖，吴  婓，丁  语，李  阳，王  兵
  

  1. 郑州大学第五附属医院血管外科，河南省郑州市  450000
  • 收稿日期:2017-04-15 出版日期:2017-06-28 发布日期:2017-07-07
  • 通讯作者: 王兵，博士，主任医师，郑州大学第五附属医院血管外科，河南省郑州市 450000
  • 作者简介:安乾，男，1983年生，河南省洛阳市人，汉族，硕士，主治医师，主要从事血管外科的基础与临床工作。
  • 基金资助:
    河南省卫生厅项目(WZ-201202015)；河南省教育厅项目(16B320023)

Degradation of a magnesium alloy stent in the rabbit abdominal aorta

An Qian, Cui Wen-jun, Si Jiang-tao, Wang Ying, Wu Fei, Ding Yu, Li Yang, Wang Bing
  

  1. Department of Vascular Surgery, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
  • Received:2017-04-15 Online:2017-06-28 Published:2017-07-07
  • Contact: Wang Bing, M.D., Chief physician, Department of Vascular Surgery, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
  • About author:An Qian, Master, Attending physician, Department of Vascular Surgery, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
  • Supported by:
    the Project of Henan Provincial Health Department, No. WZ-201202015; the Project of Henan Provincial Education Department, No. 16B320023

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摘要：

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文题释义：
可降解性AZ31镁合金支架对血管的影响：支架植入后血管再狭窄的发生和多种因素关系密切，支架的顺从度、长度、厚度、支杆之间间隔、血管内膜损伤程度等都可能参与血管狭窄的形成。支架植入后血管再狭窄的重要原因为血管内膜增生，血管内膜增生的关键机制为细胞外基质的形成及血管平滑肌的增生迁移，支架植入血管后，支架对血管有刺激作用且对血管内皮细胞有损伤作用，损伤的内皮细胞释放Von Willebrand因子复合物和纤维结合蛋白，引起血小板聚集，造成血栓形成；血小板的活化可释放血小板源性生长因子和血栓素，血小板源性生长因子促使收缩型血管平滑肌转化为合成型，合成型血管平滑肌迁移到血管内膜合成细胞外基质，引起血管管腔狭窄；早期糖蛋白等细胞外机制促进平滑肌细胞分泌细胞外基质，并促进平滑肌细胞的增生迁移；血管外膜也影响生长因子的合成和新生内膜的形成，参与血管外弹力板的收缩和血管重构，外膜成纤维母细胞向肌纤维母细胞转化，肌纤维母细胞向中膜和内膜迁移，分泌的胶原使动脉管径限制性重构，促进血管再狭窄的发生。
生物材料：用于人体组织和器官的诊断、修复或增进其功能的一类高技术材料，即用于取代、修复活组织的天然或人造材料，其作用药物不可替代。生物材料包括金属材料、无机材料和有机材料三大类；主要用在人身上，对其要求十分严格。生物材料能执行、增进或替换因疾病、损伤等失去的某种功能，而不能恢复缺陷部位。
 
背景：国外研究发现镁合金支架是安全有效的，国内对于镁合金支架降解性能的研究不多。
目的：探讨可降解AZ31镁合金支架在兔腹主动脉中的降解情况及降解过程对血管的影响。
方法：在28只新西兰大白兔腹主动脉植入可降解AZ31镁合金支架，在植入的30，60，90，120 d进行X射线检查及支架植入段血管组织学观察。
结果与结论：①X射线检查：植入后30 d，支架完全扩张，结构完整；植入后60 d，支架变形，部分支架断裂，失去支撑作用；植入后90 d，只有少量支架支杆残留，大部分支架已降解；植入后120 d，血管中无支架支杆残留，支架已完全降解；②组织学观察结果：植入后60 d的剩余支架支杆数小于植入后30 d(P < 0.05)，植入后90 d的剩余支架支杆数小于植入后30，60 d(P < 0.05)，植入后120 d的剩余支架支杆数小于植入后30，60，90 d(P < 0.05)；剩余支杆数和天数呈负相关，支架完全降解天数为植入后124.8 d。植入90 d的血管内膜面积大于植入后30，60，120 d(P <0.05)，血管管腔面积小于小于植入后30，60，    120 d(P <0.05)；后3个时间点的血管内膜面积与血管管腔面积比较差异无显著性意义；③结果表明，可降解AZ31镁合金支架在大白兔腹主动脉内完全降解时间为124.8 d，在支架植入90 d时血管内膜增生和管腔狭窄最明显，90 d后血管内膜增生和管腔狭窄逐渐减轻。

关键词: 生物材料, 材料相容性, 镁合金支架, 降解, 兔, 腹主动脉, 血管狭窄

Abstract:

BACKGROUND: Foreign studies have found that the magnesium alloy stent is safe and effective, but there are few studies on the degradation performance of magnesium alloy stents in China.
OBJECTIVE: To investigate the degradation of degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta and the effect of degradation process on vascularization.
METHODS: Twenty-eight rabbits were enrolled, and the degradable AZ31 magnesium alloy stent was implanted into the rabbit abdominal aorta. Postoperative abdominal aortic X-ray examination and histological observation were done at 30, 60, 90, 120 days after implantation.
RESULTS AND CONCLUSION: (1) X-ray examination: 30 days after implantation, the stent expanded completely with structural integrity; 60 days after implantation, the stent deformation, partial stent fracture, and lose of support were found; 90 days after implantation, only a small amount of support rod residues were found, and the majority of the stent was degraded; and 120 days after implantation, there was no support rod residual, and the stent was degraded completely. (2) Histological observation: 60 days after implantation, the number of residual support rods was less than that 30 days after implantation (P < 0.05), the number value at 90 days after implantation was lower than that at 30 and 60 days after implantation (P < 0.05), and the number value at 120 days after implantation was lower than that at 30, 60, 90 days after implantation (P < 0.05), indicating that the number of residual support rods was negatively correlated with post-implantation days. The time for complete stent degradation was 124.8 days. The intimal area at 90 days after implantation was higher than that at 30, 60, 120 days after implantation (P < 0.05), while the lumen area was smaller than that at 30, 60, 120 days after implantation (P < 0.05). There was no significant difference in the intimal area and lumen area at latter three time points after implantation. To conclude, the degradation of the degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta can be completed within 124.8 days, and at 90 days after the stent is implanted, vascular intimal hyperplasia and lumen stenosis are most serious, and then gradually reduced.

Key words: Aorta, Abdominal, Tunica Intima, Tissue Engineering

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