| 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) |
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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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