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可完全生物降解材料聚乳酸-聚羥基乙酸復(fù)合殼聚糖在人工心血管支架制備中的應(yīng)用

Artificial Coronary Vascular Stents Fabrication Using the Biodegradable Material Compounds: PLA-PGA-co-Chitosan

作者: 郭清奎  呂志前 
單位:上海交通大學(xué)附屬第六人民醫(yī)院(上海 200233)
關(guān)鍵詞: 生物可降解;高分子材料;殼聚糖;冠脈血管支架;制備 
分類(lèi)號(hào):
出版年·卷·期(頁(yè)碼):2011·30·6(652-655)
摘要:

裸金屬支架(bare metal stents, BMS)和涂層支架(drug eluting stents, DES)介入治療冠心病已在臨床廣泛應(yīng)用,但由于金屬支架的異物刺激或攜帶藥物的干擾容易引起支架內(nèi)再狹窄和血管栓塞,由聚酯、聚碳酸酐及聚磷酸酯等高分子材料制備的完全可生物降解吸收支架及藥物洗脫支架應(yīng)運(yùn)而生。目前由共聚物材料制備的人工心血管植入支架的安全性、組織及血液相容性已得到證實(shí),然而這些支架具有各自的問(wèn)題,如降解的速度、材料的柔韌度、硬度以及支撐力不均一等,尚不能滿足實(shí)際應(yīng)用的要求。本文就聚乳酸(polylactic acid,PLA)、聚羥基乙酸(polyglycolic acid, PGA)和殼聚糖在人工冠脈血管支架制備中的應(yīng)用現(xiàn)狀及研發(fā)方向予以綜述。

The first two generation scaffolds: bare metal stents (BMS) and drug eluting stents (DES), have been widely used in the treatment of coronary heart diseases. However, long term incidences of major adverse cardiovascular events and revascularization treatments are still high because of in-stent re-stenosis and thrombosis. These may be caused by chronic inflammations and vascular wall damages due to persistent metal stents stimulation. The eluting drugs within metal stents could also disturb normal growth of vascular endothelial cell, intima, tunica media, smooth muscle and epimysium. Therefore, several fully biodegradable scaffolds and drug carried stents had been manufactured using polymers polyester, polycarbonate and polyphosphate, etc. Recently, tissue and blood compatibility securities of present implanted artificial cardiovascular stents manufactured with copolymer materials had been confirmed. However, these stents could not meet the clinical demands because of  the respective problems of degradation, material rigidity, flexibility and nonuniformity of support strength. This paper reviews the current and perspective application of polylactic acid (PLA), polyglycolic acid (PGA) and chitosan in the fabrication of fully biodegradable artificial coronary vascular scaffolds.

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