切割球囊血管成形术对不稳定性心绞痛患者内皮功能的影响  

The effects of cutting balloon angioplasty on endothelium function in patients with unstable angina pectoris

作　　者：程康[1] 郭文怡[1] 王海昌[1] 贾国良[1] 李伟杰[1] 栾荣华[1] 吕安林[1] 李成祥[1] 张荣庆[1] 王晓燕[1] 

机构地区：[1]第四军医大学西京医院心血管内科,西安710032

出　　处：《中华心血管病杂志》2002年第12期728-731,共4页Chinese Journal of Cardiology

摘　　要：目的　比较切割球囊血管成形术 (CBA)与普通球囊血管成形术 (BA)对内皮功能分泌作用的影响。方法　选择 65例入院拟行冠状动脉介入治疗的不稳定性心绞痛 (UAP)患者 ,随机分为两组 ,分别接受CBA或BA ,球囊扩张后均放置支架。术前、术后即刻、术后 2h和 6h分别抽取冠状静脉窦血样 ,以硝酸还原酶法比色测定血清一氧化氮 (NO)浓度和一氧化氮合酶 (NOS)活力 ,非平衡法放射免疫测定血浆内皮素 (ET 1 )浓度。结果　两组患者靶病变情况无显著差异。CBA组的球囊最大充盈压和支架置入压力均明显低于BA组 (P <0 0 5)。CBA组术后即刻和术后 2h的血清NO浓度、NOS活力高于BA组 (P <0 0 5) ,血浆ET 1浓度低于BA组 (P <0 0 5)。结论　CBA联合支架置入术对不稳定性心绞痛患者血清NO浓度、NOS活力和血浆ET 1浓度的影响均小于BA联合支架置入术 ,这可能是前者通过减少内皮损伤导致的分泌功能减退 。Objective To investigate the effects of cutting balloon angioplasty(CBA) on serum secretion of endothelium function in patients with unstable angina pectoris Methods A total of 65 patients with unstable angina pectoris were randomly divided into CBA group and balloon angioplasty (BA) group Stents were planted in all patients after balloon angioplasty Coronary sinus blood was collected before angioplasty, immediate after angioplasty as well as 2h and 6h after angioplasty to measure the content of serum nitric oxide (NO), plasma endothelin (ET 1) and serum vigor of nitric oxide synthase (NOS) The serum level of NO and vigor of NOS were measured by chemical analysis The plasma level of ET 1 were measured by radioimmunoassay Results There was no significant difference of the characteristics of the target lesions between the two groups The maximum balloon filling pressure and the implantation pressure of stent in CBA group was significantly lower than that in BA group ( P <0 05) The serum level of NO and vigor of NOS were significantly higher in CBA group than those in BA group immediate and 2h after angioplasty ( P <0 05) The plasma level of ET 1 was significantly higher in BA group than that in CBA group immediate and 2h after angioplasty ( P <0 05) Conclusions The results suggest that CBA can significantly reduce the production of ET 1 and has lower influence on serum level of NO and vigor of NOS than that of BA This may suggest that CBA plus stent implantation produce less vessel wall injury and, consequently, better reserve secrete function of endothelium, which may account for the lower rate of restenosis and cardiovascular events of CBA

关 键 词：不稳定性心绞痛 内皮功能 经皮冠状动脉腔内血管成形术 切割球囊 一氧化氮 一氧化氮合酶 内皮素 

分 类 号：R541.4[医药卫生—心血管疾病]