Abstract:

As a major treatment for coronary artery disease, percutaneous coronary intervention (PCI) effectively enhances the survival rate of patients. However, the post-PCI in-stent restenosis has become a new cardiovascular problem that is difficult to solve. Inflammation and endothelial dysfunction, as the initiating inducing factors of in-stent restenosis, together with subsequently developed neointimal thickening and neoatherosclerosis based on which, promote the progression of in-stent restenosis. Inflammatory markers secreted by epicardial adipose tissue may directly influence the function of coronary vascular endothelial cells, smooth muscle cells and macrophages, disrupting the homeostasis of the coronary vessel wall, thereby being involved in the pathophysiological process of in-stent restenosis after coronary stenting. In addition, multiple clinical studies have shown that epicardial adipose tissue could partially predict in-stent restenosis in patients with coronary artery disease within 1 year after PCI. We reviewed the latest advances in the effect of epicardial adipose tissue on in-stent restenosis after PCI, and clinical prediction of post-PCI in-stent restenosis by epicardial fat, as well as treatment for post-PCI in-stent restenosis, providing a new idea for the prevention and treatment of post-PCI in-stent restenosis.

Key words: Percutaneous coronary intervention, In-stent restenosis, Drug-eluting stents, Epicardial adipose tissue, Coronary disease

摘要：

经皮冠状动脉介入术是冠心病的主要治疗手段，可有效提高患者的生存率，但随之而来的支架内再狭窄成为心血管领域的新难题。炎症和血管内皮功能障碍是支架内再狭窄的始动因素，在此基础上出现的新生内膜增厚和新生动脉粥样硬化共同加速了支架内再狭窄的进展。心外膜脂肪组织分泌的炎性因子可直接影响冠状动脉血管内皮细胞、平滑肌细胞和巨噬细胞功能，破坏冠状动脉血管壁的稳态，从而参与冠状动脉支架置入术后支架内再狭窄的病理生理过程。此外，多项临床研究表明心外膜脂肪组织对冠心病患者经皮冠状动脉介入术后1年内支架内再狭窄的发生有一定预测作用。因此，本文就近年来心外膜脂肪组织对经皮冠状动脉介入术后支架内再狭窄影响的研究进展、心外膜脂肪预测支架内再狭窄的临床研究进展，以及支架内再狭窄的治疗进展进行综述，以期为支架内再狭窄的预防和治疗提供新思路。

关键词: 经皮冠状动脉介入治疗, 支架内再狭窄, 药物洗脱支架, 心外膜脂肪组织, 冠心病