经皮腔内冠状动脉介入术对冠状动脉微循环阻力指数及高敏C反应蛋白的影响  

Effect of percutaneous coronary intervention on index of microcirculatory resistance and hypersensitive C-reactive protein in the coronary circulation

作　　者：杨宇[1] 梁梅冰[2] 黄石安[2] 许顶立[1] 

机构地区：[1]南方医科大学南方医院,广东广州510515 [2]广东医学院附属医院,广东湛江524001

出　　处：《中国现代医学杂志》2014年第23期59-62,共4页China Journal of Modern Medicine

摘　　要：目的探讨冠心病患者经皮腔内冠状动脉介入术(PCI)后对冠状动脉微循环及冠状动脉中高敏C反应蛋白(hs-CRP)的影响及其临床意义。方法选择该院择期PCI患者32例,于冠状动脉造影(CAG)前后、经皮冠状动脉球囊扩张(PTCA)后及支架置入后分别检测冠状动脉微循环阻力系数(IMR),采集冠状窦血、股动脉血各3 mL,采用胶乳免疫增强比浊法测定血清中hs-CRP浓度。结果 CAG前、后IMR无明显变化(P>0.05),PTCA及支架置入后IMR明显增高(P<0.05),IMR在支架置入前后比较无明显差异(P>0.05);CAG前、后hs-CRP无明显变化(P>0.05),PTCA及支架置入后冠状窦内hs-CRP明显升高(P<0.05),且IMR升高水平与hs-CRP升高水平呈正相关(r=0.613)。结论 CAG对IMR及冠状动脉内hs-CRP水平基本无影响,PTCA及支架置入后IMR及冠状动脉hs-CRP水平均升高,可能与因球囊及支架对冠状动脉血管壁的机械压迫后造成血管内皮损伤及动脉粥样斑块破裂,由此引发的炎症反应及冠状动脉微循环微血栓形成有关。[Objective] To investigate the effect of the procedure of percutaneous coronary intervention （PCI） on index of microcirculatory resistance （IMR） and hypersensitive C-reactive protein （hs-CRP） in coronary circulation. [Methods] Thirty-two patients with stable and unstable angina pectoris who underwent PCI for stenotic lesions of the coronary artery were enrolled, IMR and hs-CRP in coronary circulation was measured before and after the procedure of CAG, PTCA and PCI. Blood samples were collected from the coronary sinus and femoral artery. [Results] The level of IMR increased after the procedure of PTCA and PCI, both were significantly higher than that before the procedure （both P 〈0.05）. However, there were no significant differ- ences in the level of IMR before and after the procedure of CAG （P 〉0.05）. The serum level of hs-CRP in- creased immediately after the procedure of PTCA and PCI, both were significantly higher than that before the procedure （both P〈0.05）. However, there were no significant differences in the serum level of hs-CRP before and after the procedure of CAG （P〉0.05）. [ Conclusion] The procedure of CAG has no influence on the lev- el of IMR and hs-CRP in the coronary circulation. The procedure of PTCA and PCI promotes the release of the level of IMR and hs-CRP in the serum in the patients with chronic stable and unstable angina pectoris, which indicates that the injury of the endothehal wail which caused by mechanical compression of balloon and stent trigger the inflammatory response. And IMR and hs-CRP may be involved in the regulation of In- flammatory reaction and coronary microembolism after PTCA and stent implantation.

关 键 词：经皮腔内冠状动脉介入术 微循环阻力系数 高敏C反应蛋白 冠状动脉微循环障碍 

分 类 号：R541.4[医药卫生—心血管疾病]