冠脉内置入药物涂层支架与金属裸支架对血浆C反应蛋白水平影响的对比观察  

Comparison of effects of drug-eluting stent versus bare metal stent on plasma c-reactive protein level

作　　者：卢长青[1] 邱春光[2] 宋文翔[1] 黄斌[1] 刘鹏[3] 韩战营[2] 张彩虹[1] 

机构地区：[1]河南省中医院急诊科,河南郑州450002 [2]郑州大学第一附属医院心内科,河南郑州450052 [3]河南省胸科医院心内科,河南郑州450003

出　　处：《河南医学研究》2007年第4期311-313,共3页Henan Medical Research

摘　　要：目的:PCI术后的炎症过程的激活对血管内皮的增生与再狭窄起着重要作用,多项研究表明药物涂层支架(DES)可减少血管内再狭窄的发生,我们对冠脉内置入DES和金属裸支架(BMS)的冠心病患者的血浆CRP(C反应蛋白)水平进行比较,旨在探讨PCI术后再狭窄的发生机制。方法:置入了单个支架的冠心病稳定型心绞痛患者83例入选本研究(男54例,女29例,年龄55±14岁)DES组43例,BMS组40例,另选同期住院行冠脉造影检查显示冠状动脉不同程度的狭窄,而未行PCI的冠心病的患者35例做对照组(男24例,女11例,年龄60±12岁),分别于术前和术后48、72小时和2周后取静脉血2ml,测定血浆C反应蛋白水平,术前三组患者临床特征及冠脉造影显示的病变特征相似具有可比性,术前血浆CRP水平无显著差别。结果:术后48、72小时PCI患者较单纯进行冠脉造影的冠心病患者血浆C反应蛋白水平显著升高分别为(13.4±14.7比5.9±4.9mg/L,P<0.01);(16.7±19.8比5.4±3.9mg/L,P<0.01),亚组分析显示:DES组血浆C反应蛋白水平较BMS组显著升高,分别为(6.26±4.36比21.02±15.46mg/L,P<0.01);(4.83±3.50比15.03±9.79mg/L,P<0.01)。结论:冠脉内支架置入可显著升高血浆CRP水平,但DES与BMS相比,可明显降低血浆CRP水平,表明DES可明显抑制PCI术后诱发的急性炎症反应。Objective： After coronary stenting, inflammatory mechanisms play a crucial role in the pathogenesis of neointimal proliferation and in-stent restenosis. Drug-eluting stents （DESs） have been shown to decrease in-stent restenosis in different studies. We compared plasma C-reactive protein （CRP） levels after DES implantation with levels after bare metal stent （BMS） implantation. The purpose of this study was to investigate the effect of different stents on CRP levels. Methods： We performed percutaneous coronary intervention with a single stent in 83 patients （54 men; 55 ＋ 14 years of age; n =40 in the BMS group, n =43 in the DES group） who had stable angina. 35 patients in coronary angiography （CAG） showed coronary artery stenosis are exceeding 70% but did not performed PCI for various kinds of reason were enrolled in this study as a control group. Plasma CRP levels were measured before intervention and at 48 hours, 72 hours, 2 weeks after coronary stenting. Results： There was no difference in clinical and angiographic baseline characteristics. After PCI, plasma CRP levels were significantly higher in the stent implantation group than in the CAG group at 48 hours（ 13.4 ± 14.7 vs 5.9 ±4.9 mg/L,P 〈0.01 ）and 72 hours （ 16.7 ± 19.8 vs 5.4 ± 3.9 mg/L, P 〈 0.01 ） ; moreover after stent implantation CRP levels were significantly lower in the DES group than in the BMS group at 48 hours （6.26 ±4.36 vs 21.02 ± 15.46 mg/L, P〈0.01） and72 hours （4.83 ±3.50 vs 15.03 ±9.79 mg/L, P〈0.01）. Conclusion ： DESs showed significantly lower plasma CRP levels after coronary stenting compared with BMSs.

关 键 词：药物涂层支架 金属裸支架 C反应蛋白 

分 类 号：R54[医药卫生—心血管疾病]