经皮冠状动脉血运重建术对稳定性心绞痛患者血浆可溶性P选择素的影响  

Effect of percutaneous coronary intervention on plasma soluble P-selectin in patients with stable angina pectoris

作　　者：欧阳平[1] 施月萍 杨静[1] 

机构地区：[1]松江区中心医院心内科,上海201600

出　　处：《上海医学》2006年第8期547-548,共2页Shanghai Medical Journal

摘　　要：目的观察经皮冠状动脉血运重建术(PCI)对稳定性心绞痛患者血清可溶性P选择素的影响。方法选择我院2004年1月至2004年10月稳定性心绞痛患者21例,平均年龄(61．4±4．7)岁。分别于PCI前及PCI后2、6、72 h,采用酶联免疫吸附试验(ELISA法)测定P选择素含量。所有患者术前72 h给予阿司匹林300 mg/d、噻氯吡啶500 mg/d或氯比格雷75 mg/d抗血小板治疗。结果对21例患者冠状动脉狭窄程度＞70%的28处病变行PCI术,其中对病变进行球囊预扩张再行支架术18例(25处病变)、直接冠状动脉支架术3例(3处病变)。25处病变在球囊预扩张时发生内膜撕裂9处。21例患者术后2 h血清可溶性P选择素含量[(81．4±7．6)ng/mL]较术前[(75．4±6．8)ng/mL]增高,但差异无显著性(P=0．747)。术后6和72 h的P选择素含量与术前的差异均无显著性(P＞0．05)。结论PCI可能对冠状动脉内皮的激活影响不大,或者术前积极的抗血小板治疗至少能够部分抵消PCI对血小板和内皮的活化反应。Objective To observe the effect of percutaneous coronary intervention （PCI） on plasma soluble P-selectin in patients with stable angina pectoris. Methods The plasma soluble P-selectin was measured before and 2,6,72 hours after PCI in 21 patients with stable angina pectoris. All patients were under antiplatelet therapy （aspirin 300 mg/d and clopidogrel 75 mg/d or ticlopidine 500 mg/d） 3 days before PCI. Results PCI was performed in 21 patients with severe coronary stenosis including 28 stenotic sites. 18 patients were under taken percutaneous transluminal coronary angioplasty （PTCA） and first followed by stents placement and 3 patients were deployed stents directly. Laceration of intima occurred in 9 sites during PTCA of the 25 lesion sites. The level of soluble P-seleetin was higher but not significant 2 hours after PCI than that before PTCAE（75.4±6.8） ng/mL vs （81.4±7.6）ng/mL, P = 0. 747 ）. There was no difference in the concentrations of soluble P-seleetin between pre PCI and 6, 12 h post-PCI. Conclusion PCI does not affect the activation of coronary endothelial cells significantly, probably due to the antiplatelet therapy before PCI with partial reduction of the platelet activation and endothelial cells.

关 键 词：经皮冠状动脉血运重建术 稳定性心绞痛 P选择素 

分 类 号：R541.4[医药卫生—心血管疾病]