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Abstract：
BACKGROUND: To observe the occurrence of related complications after self-expandable metallic (SEM) airway stents implantation with different diameters at different time points, and to provide theoretical basis for the optimal chioce of existing airway stents in clinical practice.
METHODS: Healthy New Zealand white rabbits were used to establish benign tracheal stenosis models after chest CT examination. Forty-fivemodel rabbits with more than 50% of airway stenosis were divided into two groups. Small-diameter SEM stents (The ratio of stent diameter to airway diameter is nearly 1.0) were implanted in Group A in 21 rabbits, and large-diameter tracheal stents (The ratio of stent diameter to airway diameter is more than 1.2) were implanted in Group B in 24 rabbits. Stent-related complications were observed after stent implantation in 2nd,4th,8th, and 12th week by bronchoscopygross anatomy, pathological and the expressions of IL-1RA, IL-8 and MMP9 in involved tracheal.
RESULTS: The incidence rate of tracheomalacia of stent was significantly higher in group B (24/24 100%) than that in group A (1 /21,4.8%) (P < 0.05). The incidence rate of scar contracture at both ends of stent was significantly higher than in group B (11 / 24,45.8%) that in group A (2 /21, 9.5%) (P < 0.05). The pathological results of both A and B showed that the columnar epithelium of bronchial mucosa began to damage and detach, inflammatory cells infiltrated after 2nd and 4th week of stenting, The epithelium was repaired, the lamina propria glands almost disappeared, collagen fiber proliferation was obvious, and scars were formed after 8th and 12th week of stenting. ELISA results revealed that the expressions of IL-1RA, IL-8, and MMP9 were increased in the stent group than in model rabbit with benign tracheal stenosis. IL-1RA and MMP9 increased at different periods in group B, but the expression of IL-1RA and MMP9 showed a tread of increasing in the early stage and then decreasing in group A.
CONCLUSIONS: Metal stents can cause different degrees of stent-related complications in rabbits with benign tracheal stenosis. The incidence of stent-induced tracheomalacia and scar contracture were higher in Group B than that in Group A. IL-1RA, IL-8 and MMP9 may be involved in the development of complications after stentimplantation and peak value of group B movered backward. ing.
METHODS: Healthy New Zealand white rabbits were used to establish benign tracheal stenosis models after chest CT examination. Forty-fivemodel rabbits with more than 50% of airway stenosis were divided into two groups. Small-diameter SEM stents (The ratio of stent diameter to airway diameter is nearly 1.0) were implanted in Group A in 21 rabbits, and large-diameter tracheal stents (The ratio of stent diameter to airway diameter is more than 1.2) were implanted in Group B in 24 rabbits. Stent-related complications were observed after stent implantation in 2nd,4th,8th, and 12th week by bronchoscopygross anatomy, pathological and the expressions of IL-1RA, IL-8 and MMP9 in involved tracheal.
RESULTS: The incidence rate of tracheomalacia of stent was significantly higher in group B (24/24 100%) than that in group A (1 /21,4.8%) (P < 0.05). The incidence rate of scar contracture at both ends of stent was significantly higher than in group B (11 / 24,45.8%) that in group A (2 /21, 9.5%) (P < 0.05). The pathological results of both A and B showed that the columnar epithelium of bronchial mucosa began to damage and detach, inflammatory cells infiltrated after 2nd and 4th week of stenting, The epithelium was repaired, the lamina propria glands almost disappeared, collagen fiber proliferation was obvious, and scars were formed after 8th and 12th week of stenting. ELISA results revealed that the expressions of IL-1RA, IL-8, and MMP9 were increased in the stent group than in model rabbit with benign tracheal stenosis. IL-1RA and MMP9 increased at different periods in group B, but the expression of IL-1RA and MMP9 showed a tread of increasing in the early stage and then decreasing in group A.
CONCLUSIONS: Metal stents can cause different degrees of stent-related complications in rabbits with benign tracheal stenosis. The incidence of stent-induced tracheomalacia and scar contracture were higher in Group B than that in Group A. IL-1RA, IL-8 and MMP9 may be involved in the development of complications after stentimplantation and peak value of group B movered backward. ing.
摘要：
背景：观察不同时间点不同直径的自膨式金属（SEM）气道支架植入后相关并发症的发生，为临床上现有气道支架的优化设计提供理论依据。
方法：健康新西兰大白兔胸部CT检查后建立良性气管狭窄模型。将气道狭窄超过50％的四五个模型兔分为两组。A组21只兔植入小直径SEM支架(支架直径与气道直径之比近1.0)，B组24只兔植入大直径气管支架(支架直径与气道直径之比大于1.2)。第2次支架植入术后观察支架相关并发症,第四，8th,第12周通过支气管镜大体解剖，病理和IL-1RA的表达，IL-8和MMP9受累气管。
结果：B组支架后气管软化的发生率(24/24100%)明显高于A组(1/21,4.8%)(P<0.05)。支架两端瘢痕挛缩发生率B组(11/24,45.8%)明显高于A组(2/21,9.5%)(P<0.05)。病理结果A、B均显示支气管粘膜柱状上皮开始损伤和脱落,炎症细胞浸润后第2周和第4周的支架，上皮被修复了,固有层腺体几乎消失了,胶原纤维增生明显,在第8周和第12周后形成疤痕。ELISA结果显示IL-1RA的表达,支架组比良性气管狭窄模型兔IL-8和MMP9升高。B组IL-1RA和MMP9在不同时期升高,但A组IL-1RA和MMP9的表达在早期呈先升高后降低的趋势。
结论：金属支架可引起兔良性气管狭窄不同程度的支架相关并发症。B组支架诱导气管软化和瘢痕挛缩的发生率高于A组。IL-8和MMP9可能参与了支架植入术后并发症的发生和B组峰值向后移动。ING.
方法：健康新西兰大白兔胸部CT检查后建立良性气管狭窄模型。将气道狭窄超过50％的四五个模型兔分为两组。A组21只兔植入小直径SEM支架(支架直径与气道直径之比近1.0)，B组24只兔植入大直径气管支架(支架直径与气道直径之比大于1.2)。第2次支架植入术后观察支架相关并发症,第四，8th,第12周通过支气管镜大体解剖，病理和IL-1RA的表达，IL-8和MMP9受累气管。
结果：B组支架后气管软化的发生率(24/24100%)明显高于A组(1/21,4.8%)(P<0.05)。支架两端瘢痕挛缩发生率B组(11/24,45.8%)明显高于A组(2/21,9.5%)(P<0.05)。病理结果A、B均显示支气管粘膜柱状上皮开始损伤和脱落,炎症细胞浸润后第2周和第4周的支架，上皮被修复了,固有层腺体几乎消失了,胶原纤维增生明显,在第8周和第12周后形成疤痕。ELISA结果显示IL-1RA的表达,支架组比良性气管狭窄模型兔IL-8和MMP9升高。B组IL-1RA和MMP9在不同时期升高,但A组IL-1RA和MMP9的表达在早期呈先升高后降低的趋势。
结论：金属支架可引起兔良性气管狭窄不同程度的支架相关并发症。B组支架诱导气管软化和瘢痕挛缩的发生率高于A组。IL-8和MMP9可能参与了支架植入术后并发症的发生和B组峰值向后移动。ING.
