经皮腔内冠状动脉成形术对可溶性细胞粘附分子的影响  

Effects of percutaneous transluminal coronary angioplasty on serum soluble intercellular adhesion molecule-1 and P-selectin levels

作　　者：李霞[1] 王锡田[1] 毕丽珠[2] 

机构地区：[1]浙江大学医学院附属第一医院神经内科,杭州310003 [2]浙江大学医学院附属第一医院心内科

出　　处：《临床心血管病杂志》2002年第12期625-627,共3页Journal of Clinical Cardiology

摘　　要：目的 :研究经皮腔内冠状动脉成形术 (PTCA)对冠心病 (CHD)患者血清可溶性细胞间粘附分子 1(sI CAM 1)和可溶性P选择素 (Ps)水平的影响。方法 :以 2 5例冠状动脉造影 (CAG)阴性者为阴性对照 (CAG阴性组 ) ,以 2 0例CAG阳性但不宜行PTCA者为阳性对照 (CAG阳性组 ) ,观察 2 2例行PTCA的CHD患者 (PTCA组 )术前、术后冠状静脉窦 (Cs)和外周静脉 (Pv)血清sICAM 1、Ps的动态变化。结果 :PTCA组和CAG阳性组各时点Pv中sICAM 1、Ps均较同时点CAG阴性组有显著增加 (均P <0 .0 1)。PTCA组Cs中sICAM 1在术后 15min升高 (P <0 .0 5 ) ,术后 30min达最高值 (P <0 .0 1) ,Ps在PTCA后 5min即有升高 (P <0 .0 5 ) ,术后 15min达峰值。PTCA组Pv中sICAM 1在PTCA后 2 4h升高 (P <0 .0 5 ) ,术后 4 8h最高 ,Ps峰值出现在PTCA后 2 4h(P <0 .0 5 )。结论 :PTCA后血清Ps和sICAM 1相继升高 ,提示局部血管壁损伤及血小板、内皮细胞活化 。Objective:To study the effects of percutaneous transluminal coronary angioplasty (PTCA) on serum soluble intercellular adhesion molecule 1 (sICAM 1) and P selectin (Ps) in patients with coronary heart disease.Methods:Sixty seven patients underwent coronary angiography (CAG) were divided into PTCA group (n=22,CAG+ following PTCA),CAG+ group (n=20,CAG positioe without PTCA) and CAG negative group (n=25).The two latter groups served as positive and negative controls respectively. The effect of PTCA on sICAM 1 and Ps in coronary sinus (Cs) and peripheral vein (Pv) blood was observed.Results:In PTCA group and CAG positive group,the levels of sICAM 1 and Ps in Pv were all higher than those in CAG group (P< 0.01 ).In PTCA group ,the levels of sICAM 1 at the end of 15 min,30 min after PTCA in Cs and at the end of 24 h,48 h after it in Pv were higher than those before PTCA (P< 0.05 ).The Ps levels in Cs increased immediately (5 min) after PTCA and reached the peak 15min after it,while in Pv the peak time was delayed to 24 h after it.Conclusion:The higher values of Ps and sICAM 1 after PTCA indicate that the vessel wall is damaged and the platelet,endothelium are activated,which may be related to the complications after PTCA.

关 键 词：冠状动脉疾病 经腔血管成形术 经皮冠状动脉 胞间粘附分子-1 P选择素 

分 类 号：R543.3[医药卫生—心血管疾病]