Puerarin-eluting Stent Restenosis And Its Molecular Mechanism

BACKGROUNDCoronary heart disease (CHD)has a high mortality and mutilation rate, it is the cause of one of every five deaths each year in China, becoming a main disease do harm to the people's health badly. It remains a persistent public health burden in China, and to enhance the study on CHD is very important and necessarily. Stent as the supplement to prevent the restenosis after percutaneous transluminal coronary angioplasty (PTCA), can reduce the percent of restenosis, but there still has 15-20% in the In-Stent Restenosis (ISR). The main pathogenesis of the ISR maybe exist as below: the damage of endothelium cell during the stent insertion, and the hurt can promote the formation of mural thrombus, releasing angio-activity substance such as growth factor, adhesive factor and so on. All of these cytokine can contract the vessel and migration and proliferation of the smooth muscle cell. In the same time they can promote the vasoconstriction and proliferation of vessel smooth musle cell (VSMC), promoting the vessel repair after damage, and induce proliferation of endometrium and formation of ISR. So thrombosis, proliferation of endometrium and formation of new endometrium, blood vessel-remodeling is the three processes of ISR.The drug-eluting stents (DES) mainly used in clinic are Rapamycin eluting stent and Paclitaxel Eluting Stent. Paclitaxel is a kind of anti-tumour drug; it can prevent the division of the cell and promote the apoptosis of cell. But it also have cell-toxin effect and induce the occurrence of apoptosis of artery walls and aneurysm,which inhabit the application in clinic. Rapamycin eluting stent can prevent the expression of cell cycle protein and complex of cyclin dependent kinase (CDK), it can make the division of cell stop at the G1 to S step, and prevent the proliferation of the cell, thus can reduce the opportunity of ISR, but the rate of the thrombosis is high in the late period. Other more, All the two DES is too expensive for the patient in our country, so it is very important to made a new DES fitting for our living standard and having good effect.