不对称二甲基精氨酸在脑血管支架术后再狭窄形成过程中的作用  

Effect of asymmetric dimethylarginine in forming course of instent restenosis after cerebrovascular stenting

作　　者：吴云虎[1] 王殿华[1] 

机构地区：[1]昆明医学院,在读博士研究生650000

出　　处：《重庆医学》2010年第22期3032-3034,共3页Chongqing medicine

摘　　要：目的探讨内源性一氧化氮合酶(NOS)竞争抑制剂不对称二甲基精氨酸(ADMA)与脑血管支架内再狭窄(ISR)程度的相关性。方法根据105例脑血管支架术后患者有无支架内再狭窄分为两组:对照组,74例经皮脑血管成形术后但没有ISR的患者,其中颈内动脉32例,大脑中动脉11例,锁骨下动脉7例,椎动脉开口15例;应用保护伞26例。观察组,31例ISR,其中颈内动脉13例,锁骨下动脉2例,大脑中动脉7例,椎动脉开口9例;应用保护伞6例。平均随访18.5个月(3～41个月),期间进行1次脑血管造影,采血清标本后冻存,检测相关实验室指标。结果与对照组血清ADMA水平[(1.63±0.68)μmol/L]相比,观察组明显升高[(3.23±0.41)μmol/L],差异有统计学意义(P<0.01);观察组血清NO[(23.83±7.15)μmol/L],明显低于对照组[(32.87±6.72)μmol/L],差异有统计学意义(P<0.01)。两组在平均年龄、性别、血管造影特点及临床特征方面比较差异无统计学意义(P>0.05)。然而,两组在椎动脉开口和大脑中动脉ISR的发生率比较差异有统计学意义。结论脑血管支架内再狭窄程度与血清ADMA水平呈正相关,与血清NO水平呈负相关。血清ADMA和NO水平的变化是评估脑血管ISR程度非常重要的指标。Objective To investigate the correlation between endogenous inhibitor of nitric oxide synthase asymmetricdime thylarginine（ADMA） and in-stent restenosis in the patients with endovascular stenting.Methods A total of 105 patients were enrolled and divided into two groups.Control group：74 patients with percutaneous transluminal stent angioplasty but without in-stent restenosis（ISR）,in which 32 patients openings in internal carotid artery,middle cerebral artery 11,the subclavian artery 7,openings in vertebral artery 15;application of the umbrella in 26 cases.Observation groups：31 patients with ISR, in which openings in internal carotid artery 13,the subclavian artery 2,middle cerebral artery 7,openings in vertebral artery 9;application of the umbrella in 6 cases.The patients were clinically followed-up for a mean of 18.5 months（ranged 3-41 months） for angiography once and laboratory parameters.Results Compared with the serum ADMA level of control group（1.63±0.68）μmol/L,that of observation group（3.23±0.41）μmol/L was significantly higher（P〈0.01）.The serum NO level of observation group[（23.83±7.15）μmol/L] was significantly lower than that of control group [（32.87±6.72）μmol/L],（P〈0.01）.The difference of the serum ADMA and NO level before treatment between two groups was not statistically significant（P=0.279）.There was no significant difference in mean age,gender,treatment,angiographic feature and clinical features between two group（P〉0.05）.However,there was significant difference between two groups in the rate of ISR in openings in vertebral artery and middle cerebral artery.Conclusion The serum ADMA is positively correlated to the degree of in-stent restenosis and NO is negatively correlated to the degree of ISR.It is important for the diagnosis,therapy and estimation of ISR to observe the changes of the serum ADMA and NO level.

关 键 词：不对称二甲基精氨酸 脑血管支架内再狭窄 形成机制 

分 类 号：R743.3[医药卫生—神经病学与精神病学]