血管内超声评价炎性因子在冠脉支架内再狭窄中的预测价值  

Predictive Value of Inflammatory Factors Evaluated by IVUS in Coronary Artery In-stent Restenosis

作　　者：赵洪磊[1] 简政威[1] 朱苗飞[1] 芦爱霞[1] 黄虔[1] 

机构地区：[1]广东省东莞市人民医院心内科,广东东莞523000

出　　处：《临床医学工程》2012年第6期857-858,共2页Clinical Medicine & Engineering

摘　　要：目的通过比较冠脉介入术后再狭窄ISR组与非ISR组的炎性因子的水平,通过IVUS评估,探讨炎性因子预测ISR的可行性。方法对204例经皮冠脉介入(PCI)术后患者进行造影及血管内超声(IVUS)检查随访,造影证实再狭窄组31例,共38个病变;无再狭窄组173例,共229个病变;术前及随访时均行基质金属蛋白酶检测,比较两组经皮冠脉介入术前后hs-CRP、MMP-1、MMP-9变化。结果与无再狭窄组比较,再狭窄组有更大的斑块面积、内膜增生面积及更少的最小管腔面积;两组患者术前及术后的MMP-1水平无明显差异,无再狭窄组经皮冠脉介入术前后MMP-9水平无明显差异,再狭窄组术后MMP-9、Hs-CRP明显升高(P<0.05)。结论经皮冠脉介入术后支架内再狭窄患者MMP-9、hs-CRP水平较术前升高,但与再狭窄程度无关。Objective To explore the feasibility of inflammatory factors in predicting in-stent restenosis（ISR） by comparing the inflammatory factors levels between ISR group and non-ISR group with intravascular ultrasound （IVUS） after coronary intervention procedure. Methods 204 patients with percutaneous coronary intervention （PCI） were followed up and divided into two groups according the coronary angiography （CAG） results; the ISR group included 31 patients with 38 lesions and non-ISR group included 173 patients with 229 lesions. All patients were detected with intravascular ultrasound for MMP-1, MMP-9 and Hs-CRP before operation and at follow up, to compare the changes of Hs-CRP, MMP-1 and MMP-9 before and after percutaneous coronary intervention in the two groups. Results The plaque area and intima proliferation area were larger in ISR group compared with those in non-ISR group, and the MLA was smaller. The concentration of MMP-1 had no difference between preoperation and follow up between the two groups, the concentration of MMP-9, Hs-CRP obviously increased （P 0.05） in ISR group but the concentration of MMP-9 had no difference in non-ISR group. Conclusions The postoperative levels of MMP-9 and hs-CRP are higher than preoperative levels in patients with in-stent restenosis, but could not reflect the degree of restenosis.

关 键 词：基质金属蛋白酶 C反应蛋白 支架内再狭窄 血管内超声 冠状动脉造影术 

分 类 号：R541.4[医药卫生—心血管疾病]