冠心病患者不同支架置入术后对支架内内膜增生及外周血Beclin-1,LC3-Ⅱ水平的影响  

Influence of different implanted stents on in-stent intimal hyperplasia and levels of peripheral autophagyrelated protein and microtubule-associated protein 1 light chain 3-Ⅱin patients with coronary heart disease

作　　者：马军武 司丽萍 Ma Junwu;Si Liping(Department of Intervention and X-ray,Second People's Hospital of Xinxiang City,Xinxiang 453000,China;不详)

机构地区：[1]新乡市第二人民医院介入放射科,新乡453000

出　　处：《中国循证心血管医学杂志》2023年第6期730-733,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨冠状动脉粥样硬化性心脏病(冠心病,CHD)患者不同支架置入术后对支架内内膜增生及外周血血清自噬相关蛋白(Beclin-1)、微管相关蛋白1轻链3-Ⅱ(LC3-Ⅱ)水平的影响。方法选取2018年1月至2021年1月于新乡市第二人民医院介入放射科收治的符合纳入标准的114例CHD患者作为研究对象,按照植入支架类型不同分为聚合物可降解药物涂层支架(BP-DES)组(n=51)和永久性聚合物药物涂层支架(PP-DES)组(n=63)。记录两组患者手术过程中靶血管病变相关情况及置入支架长度等,术后12个月采用血管内超声技术比较两组内膜增生情况,采用酶联免疫吸附法(ELISA)检测外周血血清中Beclin-1,LC3-Ⅱ水平,术后随访1年,记录期间两组发生的主要不良心血管事件(MACE)以及支架内血栓等终点事件发生情况。结果BP-DES组靶血管病变总数大于PP-DES组,置入支架长度、病变长度小于PP-DES组(P<0.05);经超声造影检测,BP-DES组内膜中度增生率为56.86%,高于PP-DES组的38.10%,BP-DES组内膜重度增生率为19.61%,低于PP-DES组的39.68%(P<0.05);BP-DES组外周血Beclin-1,LC3-Ⅱ水平均低于PP-DES组(P<0.05);BP-DES组支架内血栓发生率为1.96%,低于PP-DES组的12.70%(P<0.05)。两组靶血管病变位置、程度、长度、内膜轻度增生率以及总MACE发生率比较,差异无统计学意义(P>0.05)。结论与PP-DES相比,冠心病患者置入BP-DES可有效改善支架内内膜增生情况,抑制其过度增生,降低Beclin-1,LC3-Ⅱ水平以抑制心肌细胞自噬,同时还可减少支架内血栓的发生。Objective To discuss the influence of different implanted stents on in-stent intimal hyperplasia and levels of peripheral autophagy-related protein(Beclin-1)and microtubule-associated protein 1 light chain 3-Ⅱ(LC3-Ⅱ)in patients with coronary heart disease(CHD).Methods CHD patients(n=114)were chosen from Department of Intervention and X-ray in the Second People’s Hospital of Xinxiang City from Jan.2018 to Jan.2021,and divided,according to types of stents,into group of biodegradable polymer-drug-coated stents(BPDES group,n=51)and group of permanent polymer drug-eluting stents(PP-DES group,n=63).The pathological changes of target vessels and length of implanted stent were recorded in 2 groups during operation process,and instent intimal hyperplasia was compared between 2 groups by using intravascular ultrasound after the operation for 12 months.The levels of serum Beclin-1 and LC3-Ⅱwere detected by using ELISA.All patients were followed up for 1 y,and the incidence of end-point events including major adverse cardiovascular events(MACE)and in-stent thrombosis were recorded in 2 groups.Results The total number of diseased target vessels was more,and length of implanted stents and length of diseased vessels were shorter in BP-DES group than those in PP-DES group(P<0.05).The results of intravascular ultrasound examination showed that the rate of moderate intimal hyperplasia was 56.86%in BP-DES group and 38.10%in PP-DES group,and rate of severe intimal hyperplasia was 19.61%in BPDES group and 39.68%in PP-DES group(P<0.05).The levels of Beclin-1 and LC3-Ⅰwere lower in BP-DES group than those in PP-DES group(P<0.05).The incidence rate of in-stent thrombosis was 1.96%in BP-DES group and 12.70%in PP-DES group(P<0.05).The comparison in lesion sites,severity and length of target vessels,rate of intimal hyperplasia and the total incidence rate of MACE showed that the difference had no statistical significance between 2 groups(P>0.05).Conclusion Compared with PP-DES,BP-DES can effectively relieve in-stent intimal hyper

关 键 词：冠心病 聚合物可降解药物涂层支架 永久性聚合物药物涂层支架 自噬相关蛋白 微管相关蛋白1轻链3-Ⅱ 

分 类 号：R541.4[医药卫生—心血管疾病]