冠状动脉内药物支架与非药物支架置入对组织因子和组织因子途径抑制物的影响  

Effects of Rapamycin Eluting Stents on Blood Tissue Factor and Tissue Factor Pathway Inhibitor in Patients With Acute Coronary Syndromes

作　　者：张高峰[1] 许澎[1] 伍旭升[1] 周亚刚[1] 乔祺[1] 俞利群[1] 施旭荣[1] 徐岭[1] 朱艳[1] 

机构地区：[1]复旦大学附属上海市第五人民医院心内科,上海市200240

出　　处：《中国循环杂志》2006年第5期330-332,共3页Chinese Circulation Journal

摘　　要：目的:了解冠状动脉内支架置入对组织因子(TF)和组织因子途径抑制物(TFPI)的影响;药物支架(雷帕霉素洗脱支架)和非药物支架对TF和TFPI影响是否存在差别。方法:将53例临床特征相似的急性冠状动脉综合征患者分成置入药物支架组(n=24)和非药物支架组两组(n= 29),测定置入支架前、置入后即刻、24小时后、48小时后血液中TF和TFPI的浓度,比较同组中不同时点TF和TFPI的变化以及药物支架组和非药物支架组对应时点的TF和TFPI的变化。结果:药物支架组和非药物支架组患者在置入支架后TF均显著升高;非药物支架组介入后即刻TFPI升高,以后降低至基线值以下,药物支架组也有类似趋势,但两组间对应时点TF和TFPI差别无统计学意义。结论:在现有的药物治疗基础上,置入药物支架和非药物支架对凝血和抗凝系统的影响类似,并不促进系统高凝状态的发生。Objective ：To study the evolution of blood tissue factor （TF） and tissue factor pathway inhibitor （TFPI） during intracoronary stent implantation in patients with acute coronary syndromes （ACS） , and to investigate the possible different effects between bare metal stent and rapamycin eluting stents. Methods：Twenty-nine consecutive ACS patients received bare metal stents （ BMS group） , and 24 received rapamycin eluting stents （ DES group）. Blood tissue factor and tissue factor pathway inhibitor were tested before, immediately and ,2d, 48 hours after procedures. Results ：Tissue factor was increased after stent implantation both in BMS and DES groups at four time points, with the effects lasting for over 48 hours （ BMS group： 1.66 ± 0.95,2.02 ± 0.97,2.52 ± 0.63,2.63 ± 0.56 IU/L; DES group： 1.45 ± 0.67, 2.28 ±0.68,2.49 ± 0.48,2.27 _± 0.51IU/L）. Tissue factor pathway inhibitor was increased immediately after stent implantation,but decreased below the baseline 24 hours after procedure （ BMS group： 0.18 ± 0.06,0.25 ± 0.10,0.16 ± 0.03,0. 15 ± 0.05ng/ml;DES group：0.18±0.04,0.21±0.07,0.16±0.02,0.15±0.04 ng/ml）. No difference was found between the two groups in respect to TF or TFPI at each corresponding time point. Conclusion：TF and TFPI were increased after stent implantation in ACS patients. They had different evolution courses. Rapamycin eluting stent showed no potent procoagulant activity compared with bare metal stents.

关 键 词：冠状动脉综合征 支架 组织因子 组织因子途径抑制物 血栓形成 

分 类 号：R541.4[医药卫生—心血管疾病]