P-选择素联合高敏C-反应蛋白对冠脉支架内再狭窄的预测价值  

Prediction of in stent restenosis by P-Selectin and Hs-CRP in patients with coronary artery disease

作　　者：简政威[1] 赵洪磊[1] 朱苗飞[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：《中国医药科学》2012年第17期22-23,73,共3页China Medicine And Pharmacy

基　　金：广东省东莞市科技计划医疗卫生类科研项目(20091051500109)

摘　　要：目的通过血管内超声(IVUS)评估冠状动脉支架内再狭窄(ISR),随访并观察冠脉介入术(PCI)后ISR组与非ISR组患者炎症因子的水平,探讨P-选择素(P-Selectin)联合高敏C-反应蛋白(Hs-CRP)预测ISR的可行性。方法对133例经皮冠脉介入术后患者进行冠脉造影及IVUS检查随访,造影证实ISR组17例,共22个病变;非ISR组103例,共138个病变;测量并比较两组外弹力膜横截面面积(EEM)、斑块面积、最小管腔面积(MLA)及内膜增生面积;术前及随访时均检测血清P-Selectin、Hs-CRP水平。结果与非ISR组比较,ISR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。其中斑块面积、内膜面积、最小管腔面积比较,差异具有统计学意义(P>0.05);外弹力膜横截面积比较差异无统计学意义(P>0.05)。非ISR组经皮冠脉介入术前后P-Selectin、Hs-CRP水平比较,差异无统计学意义(P>0.05),ISR组术后P-Selectin、Hs-CRP较术前明显升高,差异有统计学意义(P<0.05)。结论经皮冠脉介入术后支架内再狭窄患者P-Selectin、Hs-CRP水平较术前升高,监测Hs-CRP及P-选择素水平对PCI术后ISR有一定的预测作用。Objective To learn the relationship between concentration of P-Selectin, Hs-CRP and instent restenosis（ISR） after percutaneous coronary intervention（PCI）. Methods A total of 133 patients with coronary artery disease were followed up and divided to 2 group according the coronary angiography results. The instent restenosis group included 17 patients with 22 lesions while non in-stent restenosis （non ISR） group included 103 patients with 138 lesions. All of them were performed intravascular ultrasound（lVUS） and the extra-elastic membrance cross-sectional area（EEM CSA）, plaque area, minimal lumen area（MLA）, and intima proliferation area were recorded Besides, P-Selectin and Hs-CRP in all patients were detected. Results The plaque area and intima proliferation area were larger in ISR group compared with that in non-ISR group（P 〈 0.05）, while MLA were smaller. （P 〈 0.05）, EEM CSA were not statistically different between two groups. In ISR group, the concentration of P-Selectin and Hs-CRP were significantly elevated after PCI（P 〈 0.05 vs. pre-PCI）, whereas there was no significant difference in non ISR group. Conclusion P-Selectin, Hs-CRP were increased post-PCI in ISR patients. Monitoring changes of P-Selectin and Hs-CRP may be beneficial for prediction of ISR post-PCI.

关 键 词：血管内超声 冠状动脉造影术 再狭窄 P-选择素 高敏C反应蛋白 

分 类 号：R543.3[医药卫生—心血管疾病]