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药物洗脱支架(DES)在冠状动脉疾病的治疗中起到巨大作用,不但能机械支撑血管狭窄区,而且可以通过持续释放药物显著降低病灶处再狭窄率。然而,长期临床研究表明,载药DES在后期有引发血栓的风险。在DES表面载入基因药物,通过表面涂层输送系统局部缓慢释放治疗基因,能针对引起再狭窄的细胞过程进行修改。选择合适的治疗基因,可以抑制内膜增生,促进再内皮化,提高洗脱支架的有效性和安全性,是非常有前途的抗再狭窄方法。同时,良好的涂层材料不仅改善了支架表面的生物相容性,更能通过不同的基因药物输送系统有效控制治疗基因的释放速率。本文首先介绍了一部分针对再狭窄的治疗基因,在此基础上,综合阐述了基因缓释系统中使用的材料和技术,分析提炼了基因缓释系统的释放机理,举例分析了载基因洗脱支架的研究进展,并展望了该领域的发展前景。
Drug-eluting stents (DES) play a huge role in the treatment of coronary artery disease, which not only mechanically supports the vascular stenosis but also significantly reduces the rate of restenosis at the lesion by sustained drug release. However, long-term clinical studies have shown that drug-loaded DES poses a risk of thrombosis later in life. Loading the DES drug onto the DES surface and slowly releasing the therapeutic gene through the surface coating delivery system can be modified for the cellular processes that cause restenosis. Select the appropriate treatment gene, can inhibit intimal hyperplasia, re-endothelialization and improve the efficiency and safety of the elution stent, is a very promising anti-restenosis method. At the same time, a good coating material not only improves the biocompatibility of the stent surface, but also effectively controls the release rate of the therapeutic gene through different gene delivery systems. In this paper, we first introduced some therapeutic genes for restenosis. Based on this, we introduced the materials and techniques used in gene delivery system, analyzed the release mechanism of gene delivery system, Research progress, and prospects for the development of the field.