脂蛋白(α)水平和血管内超声检查预测经皮冠状动脉介入治疗后支架血管再狭窄的价值  

The value of lipoprotein (α)level and intravascular ultrasound for predicting in-stent restenosis (ISR)after percutaneous coronary intervention

作　　者：谭大伟 张建维[2] TAN Da-wei;ZHANG Jian-wei(Department of Cardiology f Ditan Hospital of Capital Medical University of Beijing 1000151 China;Department of Cardiology, Anzhen Hospital of Capital Medical University, Beijing 100029, China)

机构地区：[1]首都医科大学附属北京地坛医院心内科,北京市100015 [2]首都医科大学附属北京安贞医院心内科

出　　处：《中国心血管病研究》2019年第8期743-746,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨血清脂蛋白(α)水平[lipoprotein(α),Lp(α)]和血管内超声(intravascular ultrasound,IVUS)在预测早发冠心病中经皮冠状动脉介入术(percutaneous coronary intervention,PCI)后支架内再狭窄的价值.方法选取2012-2017年我院早发冠心病患者实施PCI 220例,随访患者经冠状动脉造影(coronary angiography,CAG)证实支架内再狭窄35例.PCI术前及随访时测定Lp(α)浓度,用血管内超声检测病变血管的外弹力膜面积、斑块面积、最小管腔面积.结果无支架内再狭窄患者PCI前后Lp(α)浓度比较未见统计学差异;支架内再狭窄患者Lp(α)浓度在PCI术后升高[(277.95±49.01)mg/L比(157.29±32.67)mg/L,P<0.01];支架内再狭窄组与支架内无狭窄组比较,两组外弹力膜面积比较未见统计学差异,两组斑块面积分别为(6.7±2.3)mm2和(5.4±1.7)mm2(P<0.05).结论血管内超声是评价早发冠心病支架内再狭窄的有效的手段,支架内再狭窄患者有更大的斑块面积,Lp(α)浓度有可能作为预测PCI术后再狭窄的无创检测指标.Objective To search the predictable value of lipoprotein ( a )[Lp (a )] and intravascular ultrasound (IVUS) for in-stent restenosis ( ISR) after percutaneous coronary intervention ( PCI) in patients with premature coronary heart disease. Methods 220 patients underwent PCI from 2012 to 2017 were followed up. Coronary angiogram (CA G) found 35 patients with in-stent restenosis (ISR ). Lp ( a ) was determined with ELLA.SA before and after PCI and the external elastic membrance area, plaque area and minimal lumen area were detected with IVUS. Results L p (a ) before and after PCI were similar in patients without ISR. But elevated after PCI in patients with ISR[(277.95±49.01 )m g/L vs.(157.29±32.67)m g/L,P<0.01 ];external elastic membrance area in ISR group and non-ISR group were similar. But minimal lumen area was lager in ISR group than that in non-ISR group ( 6.1 ± 2 3 ) mm2 and ( 5.4± 1.7) mm2 ( P<0.05). Conclusion IVUS is an effective ways to access the ISR. There are larger plaque area in patients with premature coronary heart disease with ISR. L p (a ) can be used for predicting ISR in patients with premature coronary heart disease.

关 键 词：早发冠状动脉疾病 血清脂蛋白(Α) 血管内超声 支架内再狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]