Tanguay Jean-François, Hammoud Talal, Geoffroy Pascale, Merhi Yahye
Experimental Interventional Laboratory, Montreal Heart Institute and University of Montreal, Quebec, Canada.
J Endovasc Ther. 2003 Oct;10(5):968-77. doi: 10.1177/152660280301000521.
To investigate the relationship between platelets and neutrophils and the progression of neointimal hyperplasia after angioplasty versus stenting of porcine coronary arteries.
Balloon angioplasty or implantation of a balloon-expandable stent was randomly performed in the left and right coronary arteries of 16 Yorkshire swine; the animals were euthanized 1 hour (n=6), 24 hours (n=4), or 1 month (n=6) after the interventions. The adhesion of chromium 51-labeled platelets and indium 111-labeled neutrophils was quantified (per cm2), and histological and morphometric analyses were performed.
The acute adhesion of platelets and neutrophils observed on the injured segments 1 hour after the interventions was similar between the treated groups. However, at 24 hours, stenting was associated with 2-fold more platelets and 3-fold more neutrophils (p<0.05) than was dilation, and stented arteries remained more thrombogenic at 1 month (p<0.05). Neointimal formation was more intense after stent implantation (3.80+/-0.77 mm, p<0.05) than after dilation (0.81+/-0.21 mm), and it correlated positively with the adhesion of platelets (r=0.81, p<0.002) and neutrophils (r=0.69, p<0.01).
These results indicate that stent implantation is associated with a more intense acute and chronic, low-grade inflammatory response than is dilation. It appears that the chronic inflammatory response is, at least in part, platelet- and neutrophil-driven and contributes to the progression of neointimal proliferation after stenting.
研究猪冠状动脉血管成形术与支架置入术后血小板与中性粒细胞之间的关系以及新生内膜增生的进展情况。
对16只约克郡猪的左右冠状动脉随机进行球囊血管成形术或植入球囊扩张支架；干预后1小时（n = 6）、24小时（n = 4）或1个月（n = 6）对动物实施安乐死。对铬51标记的血小板和铟111标记的中性粒细胞的黏附情况进行定量分析（每平方厘米），并进行组织学和形态学分析。
干预后1小时在损伤节段观察到的血小板和中性粒细胞的急性黏附情况在各治疗组之间相似。然而，在24小时时，与扩张组相比，支架置入组的血小板数量多2倍，中性粒细胞数量多3倍（p<0.05），并且在1个月时，置入支架的动脉血栓形成倾向更强（p<0.05）。支架植入后新生内膜形成比扩张后更明显（3.80±0.77毫米，p<0.05），且与血小板黏附（r = 0.81，p<0.002）和中性粒细胞黏附（r = 0.69，p<0.01）呈正相关。
这些结果表明，与扩张相比，支架植入与更强烈的急性和慢性低度炎症反应相关。慢性炎症反应似乎至少部分由血小板和中性粒细胞驱动，并促进支架置入术后新生内膜增殖的进展。
