文章摘要
谢祖龙,房 炎,王学懂,田进伟,杜华安,于 波.血流剪切力对支架内新生动脉粥样硬化形成的影响[J].,2018,(8):1479-1483
血流剪切力对支架内新生动脉粥样硬化形成的影响
Effect of Shear Stress on the Formation of In-stent Neoatherosclerosis
投稿时间:2017-12-05  修订日期:2017-12-25
DOI:10.13241/j.cnki.pmb.2018.08.015
中文关键词: 支架内斑块  血流剪切力  光学相干断层成像  超声
英文关键词: In-stent neoatherosclerosis  Shear stress  Optical coherence tomography  Doppler ultrasound
基金项目:国家自然科学基金项目(81571749; 81330033)
作者单位E-mail
谢祖龙 重庆医科大学附属第二医院心血管内科 重庆 400010 xiezulong1989@163.com 
房 炎 哈尔滨医科大学附属第二医院心血管内科 黑龙江 哈尔滨 150001  
王学懂 哈尔滨医科大学附属第二医院心血管内科 黑龙江 哈尔滨 150001  
田进伟 哈尔滨医科大学附属第二医院心血管内科 黑龙江 哈尔滨 150001  
杜华安 重庆医科大学附属第二医院心血管内科 重庆 400010  
于 波 哈尔滨医科大学附属第二医院心血管内科 黑龙江 哈尔滨 150001  
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中文摘要:
      摘要 目的:探讨血流剪切力对支架内新生粥样硬化斑块形成的影响。方法:在6只新西兰白兔右髂动脉植入金属裸支架,术后高脂喂养8周。将支架按长度均等分为近中远3段,应用多普勒超声测量各支架段血管的血流速度和血管内径,根据Poiseuille定律计算出术后即刻及术后8周时各支架段的平均血流剪切力。应用光学相干断层成像技术(optical coherence tomography,OCT)检测术后8周支架内新生内膜的生长情况及特性。结果:成功建立支架内斑块动物模型。术后即刻近中远支架段的血流剪切力分别为4.25±0.92, 2.49±1.07, 1.67±0.49Pa(P<0.05);术后8周近中远支架段血流剪切力分别为20.40±6.07, 11.09±1.74, 7.97±0.26Pa(P<0.05),均较术后即刻明显升高(P<0.001);术后8周近中远支架段的内膜异质性发生率分别为86.67%,53.33%,41.12%(P<0.05);术后8周近中远支架段OCT检测的富含脂质斑块的发生率分别为53.3%,20%,0%(P<0.05)。结论:支架内新生粥样硬化斑块的发生可能与较高的血流剪切力相关。
英文摘要:
      ABSTRACT Objective: To study the impact of shear stress on the formation of in-stent neoatherosclerosis. Methods: The bare-metal stents were implanted in the right iliac arteries of 6 New Zealand White rabbits, which were then fed with a high-fat diet for additional 8 weeks. Each implanted stent was equally divided into 3 segments and the blood flow velocity and blood vessel diameter was measured with Doppler ultrasound. The average shear stress forces were calculated immediately after and 8 weeks after stent implantation according to Poiseuille's law. The characteristics of in-stent neointima 8 weeks after stent implantation were evaluated using optical coherence tomography. Results: An experimental animal model of in-stent neoatherosclerosis was successfully established. Shear stress forces of the proximal-, middle- and distal-stent segments were 4.25±0.92, 2.49±1.07, 1.67±0.49Pa (P<0.05) immediately after stent implantation, which significantly increased to 20.40±6.07, 11.09±1.74, 7.97±0.26Pa respectively (P<0.05) after 8 weeks (the differences between baseline and follow-up, all P<0.001).The incidence of neointima heterogeneity of proximal-, middle-, distal-stent segments 8 weeks after stent implantation were 86.67%,53.33%,41.12% (P<0.05) and the occurrences of in-stent neoatherosclerosis of the 3 segments were 53.3%, 20%, 0% respectively (P<0.05). Conclusion: These data suggests that the formation of in-stent neoatherosclerosis may be associated with higher shear stress.
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