冠状动脉支架术后再狭窄血管重构与脂联素、高敏C反应蛋白和内皮功能的相关性研究  

Relationships between vascular remodeling of coronary artery in-stent restenosis and adiponectin,highsensitive C-reactive protein and endothelial function

作　　者：李国栋[1] 郑燕列[1] 

机构地区：[1]广州军区广州总医院157分院综合内科,广州510510

出　　处：《岭南心血管病杂志》2016年第2期131-133,161,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的分析冠状动脉支架术后再狭窄(in-stent restenosis,ISR)血管重构与脂联素(adiponectin,APN)、高敏C反应蛋白(high-sensitive C-reactive protein,hs-CRP)和内皮功能的相关性关系。方法 60例行经皮冠状动脉支架术治疗的冠状动脉粥样硬化性心脏病(冠心病)患者根据术后是否出现ISR分为ISR组(n=30例)和对照组(n=30例)。采用酶联免疫吸附试验检测两组患者治疗前、后血清APN、hs-CRP浓度;采用血管内超声成像系统和彩色多普勒超声诊断仪检测冠状动脉重构指数(remodeling index,RI)和内皮依赖性舒张功能(flowmediated dilation,FMD),分析RI与血清APN、hs-CRP浓度及FMD的相关性。结果 ISR组治疗后血清hs-CRP浓度明显高于非ISR组,差异有统计学意义(P<0.05);而血清APN浓度及RI、FMD明显低于对照组,差异有统计学意义(P<0.05);RI与血清APN浓度及FMD呈显著正相关性关系(r=0.547,P<0.05;r=0.428,P<0.05);与血清hs-CRP浓度呈显著负相关性关系(r=-0.602,P<0.05)。结论血清APN、内皮功能及炎症因子与ISR的发生、发展有着密切的相关性。Objectives To analyze the relationship between vascular remodeling of coronary artery in-stent restenosis （ISR） and adiponeetin （APN）, high-sensitive C-reactive protein （hs-CRP） and endothelial function. Methods Totally 60 patients with coronary heart disease who underwent percutaneous coronary stenting were divided into ISR group （n=30） and control group （n=30） according to the occurrence of postoperative ISR. Serum concentrations of APN and hs-CRP of the two groups before and after treatment were detected by enzyme-linked immunosorbent test, and coronary artery remodeling index （RI） and flow-mediated dilation （FMD） were deteced by intravascular ultrasound and color Doppler ultrasonic diagnostic apparatus. The relationships between RI and serum concentrations of APN, hs-CRP, and FMD were analyzed. Results Serum concentration of hs-CRP in ISR group after treatment was significantly higher than that in control group （P〈O.05）, while serum concentrations of APN, RI and FMD were significantly lower than those in control group （P〈0.05）. RI had a significantly positive correlation with serum concentrations of APN and FMD （r=0.547, P〈0.05 ; r=0.428, P〈0.05）, and showed a significantly negative correlation with serum concentration of hs- CRP （r=-0.602, P〈0.05 ）. Conclusions Serum concentrations of APN, endothelial function and inflammatory factors have a close relationship with the occurrence and development of ISR.

关 键 词：冠状动脉支架术后再狭窄 血管重构 脂联素 高敏C反应蛋白 内皮功能 

分 类 号：R541.4[医药卫生—心血管疾病]