不稳定型心绞痛病人PCI后脂联素及相关因子变化  

CHANGES OF SERUM LEVELS OF ADIPONECTIN AND RELATED CYTOKINES AFTER PCI IN PATIENTS WITH UNSTABLE ANGINA PECTORIS

作　　者：王梦娟[1] 田建会[1] 王霞霞[1] 马蕾[2] 郑信景[1] 

机构地区：[1]青岛大学医学院附属医院心内科,山东青岛266003 [2]青岛大学医学院放射科,山东青岛266003

出　　处：《齐鲁医学杂志》2013年第3期253-255,258,共4页Medical Journal of Qilu

摘　　要：目的探讨不稳定型心绞痛(UA)病人经皮冠状动脉介入治疗(PCI)术后脂联素(ADP)及相关因子在减轻心肌细胞再灌注损伤中的作用。方法将114例UA病人根据冠状动脉造影(CAG)结果及心肌梗死溶栓试验(TIMI)血流分级分为对照组(CAG结果正常)、TIMI0～1组和TIMI2～3组,后两组病人均行PCI术,测定并比较各组病人术前及术后12hADP、血脂谱、超敏C反应蛋白(hs-CRP)、肌酸激酶同工酶(CK-MB)、高敏肌钙蛋白T(hs-TnT)、丙二醛(MDA)、超氧化物歧化酶(SOD)、白细胞介素18(IL-18)的浓度。结果 TIMI0～1组PCI前后各指标检测结果比较差异有显著性(t=-2.831～6.073,P<0.05、0.01)。与对照组比较,TIMI0～1组PCI前后ADP、SOD、IL-18、hs-CRP及MDA浓度差值差异有显著性(F=5.505～11.336,q=4.665～6.699,P<0.01),TI-MI2～3组ADP、SOD、IL-18、hs-CRP及MDA浓度差值差异有显著性(q=2.811～3.067,P<0.05)。TIMI0～1组病人PCI前后血清ADP浓度差值与SOD浓度差值呈正相关(r=0.487,P<0.01),与IL-18、MDA及hs-CRP浓度差值呈负相关(r=-0.355～-0.454,P<0.05、0.01)。结论脂联素具有抗炎、抗脂质过氧化的作用,能够减轻术后心肌细胞损伤,特别是再灌注损伤。Objective To study the effect of serum adiponectin （ADP） and related factors on relieving myocardial cell reperfusion injury in patients with unstable angina pectoris （UAP） after percutaneous coronary intervention （PCI）. Methods According to the coronary angiography results and thrombolysis in myocardial infarction （TLMI） flow grade, 114 patients with UAP were divided into control group-with normal coronary angiography results, TIMI01 group and TIMI23 group, the patients in the latter two groups underwent PCI. Before and 12 hours after PCI, the serum levels of ADP, blood fat, hs-CRP, CK-MB, hs- TnT, MDA, SOD and IL-18 were measured and compared between each group. Results Before and after PCI： The levels of each parameter in TlMI0-1 group were significantly different （t= 2.831 6.073;P〈0.05,0.01）; Compared with the control group, the differences of ADP, SOD, IL-18, hs-CRP and MDA in the TIMI0-1 group and TIMI2 3 group were significant （F= 5.505--11.336;q=4.665--6.699;P〈0.01） and （q=2.811--3.527,P〈0.05）, respectively. In TIMI0 I group, the concentration difference of ADP was positively correlated with that of SOD （r=0.487,P〈0.01） and negatively with IL-18, MDA and hs-CRP （r=-0.355--0.454,P〈0.05,0.01）. Conclusion ADP has an action of anti-inflammatory and anti lipid peroxidation, which can relieve postoperative myocardial injury, reperfusion injury in particular.

关 键 词：心绞痛 不稳定型 血管成形术 经腔 经皮冠状动脉 脂联素 超氧化物歧化酶 丙二醛 白细胞介素18 C反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]