稳定性心绞痛患者冠状动脉支架术中的炎症反应及意义  

Inflammatory response to coronary stenting in patients with stable angina

作　　者：陈娟[1] 陈刚[1] 周逸[1] 陈曼华[1] 黎莉[1] 李斌[1] 夏文君[1] 

机构地区：[1]武汉市中心医院心内科,武汉430014

出　　处：《临床心血管病杂志》2012年第6期416-418,共3页Journal of Clinical Cardiology

基　　金：武汉市卫生局科研项目(No:WX10A04)

摘　　要：目的:探讨稳定性心绞痛患者经皮冠状动脉(冠脉)介入治疗(PCI)术中的炎症反应及其意义。方法:回顾性分析78例稳定性冠心病患者临床资料,根据术后6个月左右行冠脉造影复查后分为再狭窄组(10例)及无再狭窄组(68例),分析其在PCI术前、术后即刻、术后24h、术后72h及复查冠脉造影前的超敏C反应蛋白(hs-CRP)、血管细胞黏附分子-1(VCAM-1)、细胞间黏附分子-1(ICAM-1)水平。结果:PCI术后所有患者hs-CRP、VCAM-1水平与术前相比均明显升高,且再狭窄组患者术后72hhs-CRP[(9.81±4.76)mg/dl∶(6.64±2.89)mg/dl,P<0.05]高于无再狭窄组;术后24h时再狭窄组hs-CRP水平高于无再狭窄组[(3.77±1.52)mg/dl∶(2.43±1.05)mg/dl,P<0.05];两组ICAM-1水平在PCI术前、术后即刻、术后24h及术后72h均差异无统计学意义,但在术后72h时,再狭窄组ICAM-1水平与术前相比明显增高[(7.23±3.46)ng/ml∶(4.35±2.07)ng/ml,P<0.05]。结论:稳定性心绞痛患者PCI术后24h、72h时hs-CRP、VCAM-1明显增高提示患者可能出现支架内再狭窄;术后72hICAM-1水平较术前明显增高提示支架内再狭窄发生概率较高。Objective：To evaluate inflammatory response to PCI in patients with stable coronary artery disease. Method：We analyzed clinical data of 78 patients retrospectively,and divided into restenosis group（10 cases） and non restenosis group（68 cases） according to the coronary angiography result that executed again 6-months after PCI.Then we measured the level of hs-CRP,VCAM-1,ICAM-1 pre-PCI,pos-PCI,24 hours after PCI（24 h-PCI）,72 hours after PCI（72 h-PCI） respectively. Result：In all patients after PCI,hs-CRP,VCAM-1 level were significantly higher than pre-PCI.In restenosis group,hs-CRP and VCAM-1 level in 72 h-PCI were higher than those in non restenosis group [（9.81±4.76）mg/dl vs（6.64±2.89）mg/dl,P〈0.01];[（109.45±48.93）ng/ml vs（86.64±42.62）ng/ml,P〈0.05];hs-CRP level in 24 h-PCI was higher in restenosis group than in non restenosis group [（3.77±1.52）mg/dl vs（2.43±1.05）mg/dl,P〈0.05].There was no significant difference of ICAM-1 between 2 groups,while in restenosis group,the ICAM-1 level in 72 h-PCI was higher than before [（7.23±3.46）ng/ml vs（4.35±2.07）ng/ml,P〈0.05]. Conclusion：In patients with stable angina,the increasing level of hs-CRP,VCAM-1 after PCI maybe indicate the restenosis after PCI.If the level of ICAM-1 in 72 h-PCI is higher than pre-PCI,it also can be regarded as a predictor of restenosis.

关 键 词：心绞痛 稳定性 冠脉支架 炎症反应 再狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]