PTCA和BMS置入术对冠心病患者血液中ET、SOD-1和TNF的影响及临床意义  

Clinical Significance and Effect of PTCA and BMS on Levels of ET,SOD-1,TNF in Patients with Coronary Heart Disease

作　　者：周军[1] 王腾[2] 秦牧[2] 胡河[2] 曹红[2] 唐其柱[2] 

机构地区：[1]湖北省枝江市人民医院心内科,邮政编码枝江443200 [2]武汉大学人民医院心内科/武汉大学心血管病研究所

出　　处：《微循环学杂志》2012年第1期46-48,51,I0002,共5页Chinese Journal of Microcirculation

摘　　要：目的:探讨经皮冠脉腔内血管成形术(PTCA)和裸金属支架(BMS)置入术对冠心病(CHD)患者血液中内皮素(ET)、超氧化物歧化酶(SOD-1)和肿瘤坏死因子(TNF)的影响及临床意义。方法:检测对象分为对照组、PTCA组和BMS组,采用放射免疫分析法测定各组ET、SOD-1和TNF的放免活性并作对比分析。结果:PTCA组和BMS组术前ET、SOD-1和TNF水平均显著高于对照组(P<0.05或P<0.01),两手术组术后15min和2h的ET水平显著高于术前(P<0.05和P<0.01);SOD-1水平在术后2h达到最大值(P<0.01),术后24h显著低于术后2h(P<0.05);TNF水平术后6h、24h显著高于术前(P<0.05或P<0.01),术后24h明显高于术后2h(P<0.05)。BMS组ET和TNF水平在术前和术后各观察时点均较PTCA组增高,尤以术后24h更加明显(P<0.05);BMS组SOD-1在术前及术后2h较PTCA组增高,术后6h显著低于PTCA组(P<0.05)。结论:PTCA或BMS时CHD患者血液ET、SOD-1和TNF水平呈不同时相变化,可能与术后早期血管弹性回缩及后期血管重塑等病理生理改变引发的再狭窄有关。Objective:To investigate clinical significance and effect of percutaneous transluminal coronary angioplasty(PTCA) and bare metal stent(BMS) on ET,SOD-1,TNF in patients with coronary heart disease(CHD).Method:The levels of ET,SOD-1 and TNF in control,PTCA and BMS group were examined and analyzed with radioimmunoassay before and after operations as soon as 15thmin,2ndh,6thh,24thh following operation.Results:It was indicated that the levels of ET,SOD-1 and TNF in PTCA group or BMS group before operation were significantly increased(compared to control group,P<0.05 or P<0.01,respectively).The level of ET was obviously increased at 15thmin and 2ndh(compare to group before operation,P<0.05 and P<0.01,respectively),but decreased at 24thh(compared to 2ndh,P<0.05).The level of SOD-1 arrived the peak at 2ndh(compared to group before operation,P<0.01),but decreased at 24thh(compare to 2ndh,P<.05).The level of TNF was gradually increased by step of examination time,and significantly exceeded before operation at 6thh and 24thh(P<0.05 and P<0.01,respectively).And the level of TNF was dramaticly increased at 24thh compared with that at 2ndh(P<0.05).Compared with PTCA group,the level of ET and TNF in BMS group were all increased in every examination time,only that was more significant in BMS group than that in PTCA group at 24thh(P<0.05).Moreover,the level of SOD-1 in BMS group was increased at 2ndh,but significantly decreased at 6thh(compared with PTCA group,P<0.05).Conclusion:The present study showed that the PTCA or BMS has some significant effects on levels of ET,SOD-1 and TNF.It was suggested that ET,SOD-1 and TNF might contribute to occurrence of restenosis by participation the pathophysiological changes on the formation and proliferation of neointima after PTCA and BMS in CHD patients.

关 键 词：冠心病患者 SOD-1 PTCA 临床意义 经皮冠状动脉腔内成形术 置入术 BMS TNF 

分 类 号：R541.4[医药卫生—心血管疾病]