冠心病患者经皮腔内冠状动脉介入术中肾上腺髓质素及肿瘤坏死因子与术后再狭窄的关系  

The Effect of Adrenomedullin and Tumour Necrosis Factor-α Variation in the Coronary Circulation During Percutaneous Coronary Intervention on Restenosis

作　　者：刘海潮[1] 刘映峰[2] 李志樑[2] 唐朝枢[3] 

机构地区：[1]华中科技大学同济医学院附属同济医院心内科,湖北省武汉市430030 [2]南方医科大学附属珠江医院心内科,广东省广州市510028 [3]北京大学第一医院心血管病研究所,北京市100083

出　　处：《中国动脉硬化杂志》2006年第3期224-226,共3页Chinese Journal of Arteriosclerosis

基　　金：国家重点基础研究发展项目(G200056905)

摘　　要：目的探讨冠心病患者行经皮腔内冠状动脉介入术中冠状动脉循环中肾上腺髓质素及肿瘤坏死因子浓度变化与再狭窄的关系。方法70例冠心病患者分别于术前、冠状动脉造影后、球囊扩张后采集冠状静脉窦血,采用放射免疫法测定肾上腺髓质素、肿瘤坏死因子α的浓度。术后6个月或有心肌缺血复发证据时复查冠状动脉造影。结果随访发现,再狭窄发生率为21.4%(15/70),再狭窄组术前及冠状动脉造影后冠状动脉循环中肾上腺髓质素、肿瘤坏死因子α含量与无再狭窄组无明显差异(P>0.05),球囊扩张后再狭窄组冠状动脉循环中肾上腺髓质素、肿瘤坏死因子α含量分别为40.1±1.1pg/L和15.0±0.4pg/L,明显高于无再狭窄组(肾上腺髓质素为35.8±1.6pg/L,肿瘤坏死因子α为10.6±0.4pg/L),两组的差异有非常显著性统计学意义(P<0.01)。结论球囊扩张后冠状动脉循环中肾上腺髓质素和肿瘤坏死因子α水平与术后再狭窄关系密切,可作为预测经皮腔内冠状动脉介入术后再狭窄的参考指标。Aim To evaluate the effect of adrenomedullin and turnout necrosis factor-avafiation in the coronary circulation in coronary heart disease patients during percutaneous coronary intervention on restenosis. Methods Blood samples of 70 patients with coronary heart disease were obtained from both the coronary sinus and femoral artery before and after angjoplasty, immediately after percutaneous transluminal coronary angioplasty. Plasma adrenomedullin, tumour necrosis factor-alevels were measured by radioimmunoassay. Coronary angingraphy was performed again at 6 months after percutaneous coronary intervention or having evidents of myocardial ischemia. Results Restenosis occurred in 21.4% （15/70） of patients. Before percutancous coronary intervention, the adrenomedullin, turnout necrosis factor-alevels in coronary sinus were no significant differences in patients with or without restenosis. However, adrenomedullin and turnout necrosis factor-alevels after percutaneous transluminal coronary angioplasty in patients with restenosis （40.1 ± 1.1 pg/L and 15.0 ± 0.4 pg/L） were higher than those without restenosis （35.8 ± 1.6 pg/L and 10.6± 0.4 pg/L, all P〈0.01）. Conclusions There was a high incidence of restenosis in patients with a increasing adrenomedullin, tumour necrosis factor-alevels in coronary sinus after percutaneous tranaluminal coronary angioplasty. It shows that adrenomedullin,tumour necrosis factor-αin coronary sinus after percutaneous transluminal coronary angioplasty have a close relationship with restenosis and may become clinical prognostic indicator of estimating restenosis.

关 键 词：内科学 肾上腺髓质素 肿瘤坏死因子 经皮腔内冠状动脉介入术 介入术后再狭窄 

分 类 号：R5[医药卫生—内科学]