Grossman Jessica D, Grossman William
Clinical Development, Accuray, Inc., Sunnyvale, California, USA.
Rev Cardiovasc Med. 2002 Summer;3(3):138-44.
Several clinical trials of therapeutic angiogenesis in patients with coronary artery disease have shown clinical improvement and provided some objective evidence of improved perfusion and left ventricular function. Larger-scale, placebo-controlled trials, as well as studies of combinations of growth factors and the use of endothelial progenitor-cell or stem-cell supplementation, are in progress. Revascularization of ischemic myocardium with angiogenic compounds and without the mechanical manipulation of atherosclerotic vessels has great potential in the treatment of coronary artery disease. If it is proven to be both safe and efficacious, the revascularization of tissue biologically via medical or gene therapy will be a major advance in the treatment of patients with a diffuse disease that is not amenable to conventional therapy and in the augmentation of revascularization in patients undergoing traditional surgical therapies.
多项针对冠心病患者的治疗性血管生成临床试验已显示出临床改善，并提供了灌注改善和左心室功能改善的一些客观证据。更大规模的安慰剂对照试验，以及生长因子组合研究、内皮祖细胞或干细胞补充剂的使用研究正在进行中。使用血管生成化合物使缺血心肌再血管化且不进行动脉粥样硬化血管的机械操作，在冠心病治疗中具有巨大潜力。如果经证明既安全又有效，那么通过医学或基因疗法在生物学上实现组织再血管化，将是治疗无法接受传统疗法的弥漫性疾病患者以及增强接受传统外科治疗患者的再血管化方面的一项重大进展。
