冠状动脉内支架植入术前后QTd与血管活性物质及ROS水平的关系  

Relationship between QT dispersion and levels of plasma vasoactive peptides and reactive oxygen species before and after the stents implantation

作　　者：李妍[1] 贾国良[1] 陈兰芳[1] 

机构地区：[1]第四军医大学西京医院心血管内科,陕西西安710033

出　　处：《第四军医大学学报》2001年第21期1985-1988,共4页Journal of the Fourth Military Medical University

摘　　要：目的　探讨冠状动脉内支架植入术前后冠心病患者QT离散度与血浆内皮素 (ET- 1)、降钙素基因相关肽(CGRP)、丙二醛 (MDA)、超氧化物歧化酶 (SOD)、空腹血糖(FBG)、平均动脉压 (MAP)、年龄、性别、体质量的关系 .方法　对行支架植入术的 5 1(男 46 ,女 5 )例冠心病患者检测血浆ET- 1,CGRP,MDA,SOD水平 .所有对象在抽血当天同步记录 12导联心电图 ,测算 QT离散度 (QTd)和心率校正的 QTd(QTcd) .并检测和记录 FBG,MAP,年龄、性别、体质量 .以QTcd为因变量 ,以上述检测的 9个指标为自变量 ,进行多重逐步回归和相关分析 .结果　术前各变量依次被选入方程的顺序是 ET- 1,MDA,MAP和 FBG. QTcd与血浆 ET- 1,MDA,MAP显著正相关 ,而与 FBG呈负相关 .支架术后 2 4h时 ,QTd和 QTcd均明显下降 [(4 0± 11)和 (38± 12 )与 (6 4±18)和 (6 0± 17) ](P<0 .0 5 ) ,各变量依次被选入方程的顺序是ET- 1,MDA,且 QTcd与血浆 ET- 1,MDA显著相关 .结论　冠心病患者血浆 ET- 1,MDA,MAP增高及 FBG偏低是QTcd增大的独立相关因素 ,支架治疗后 QTd和 QTcd明显减小 ,血浆 ET- 1。AIM To investigate the relationship between [e-mail] QT dispersion (QTd) and plasma concentrations of endothelin 1 (ET 1), calcitonin gene related peptide (CGRP), malonaldehyole (MDA), superoxide dismutase (SOD), fasting blood glucose (FBG), mean arterial pressure (MAP), sex, age, body weight (BW) before and after the stents implantation in patients with coronary artery diseases. METHODS 51 patients undergoing stents implantation and 28 healthy control were included. The blood samples were analyzed for plasma ET 1, CGRP, MDA, SOD, FBG. At the same time, the characteristics such as sex, age, body weight (BW), mean arterial pressure (MAP), were recorded. Stepwise regression analysis was used to assess the correlation between QTd and the above nine variables. RESULTS The QTd and QTcd after the stents implantation were much lower than those before the procedure [(40±11) and (38±12) vs (64±18) and (60±17)] ( P <0.05). Before the stents implantation, QTcd was independently, significantly and positively correlated with ET 1, MDA and MAP; while FBG was an independent, inversely correlated variable. In comparison with the pre stent, QTcd was independently, significantly and positively correlated with ET 1 and MDA. CONCLUSION In CHD the increase of plasma ET 1, MDA, MAP and decrease of FBG are important independent factors that cause QTcd increasing. The stent implantation can reduce QTd and QTcd, of which the lowering of plasma ET 1 and MDA levels are the independent factors.

关 键 词：冠心病 支架 QT间期离散度 血管活性肽 

分 类 号：R541.4[医药卫生—心血管疾病] R654.2[医药卫生—内科学]