摘要
目的研究经皮冠状动脉(冠脉)支架术后再狭窄患者血管内皮功能的变化及其临床意义。方法67例接受经皮冠脉支架术的冠心病患者术前术后及18例正常对照组测定肱动脉流量介导的舒张(FMD)和非内皮依赖性舒张功能(NMD)。结果再狭窄与无再狭窄组支架术前的FMD分别为(22.4±4.2)%和(22.6±6.4)%,与正常对照组(25.9±5.2)%比较显著减低(P<0.05)。支架术后6个月再狭窄16例,占23.9%。再狭窄组与无再狭窄组的FMD比较,术前差异无显著性(P>0.05),但术后再狭窄组的FM(D18.4+3.9)%较术前明显降低(P<0.01),而无再狭窄的术前术后(22.6±6.4)%与(21.9±6.9)%差异无显著性。结论支架术后再狭窄组的内皮依赖性舒张功能显著减低,应采取措施保护和修复血管内皮功能。无创性超声检测肱动脉FMD对预测冠脉内支架术后再狭窄具有一定的临床意义。
[Objective] To investigate the endothelial function in patients with restenosis after percutaneous transluminal coronary stenting and their clinical significance. [Methods] Flow-mediated vascular dilation （FMD） and non-flow-mediated vascular dilation （NMD） of brachial artery were measured in 67 patients of coronary artery disease before and after 6 months of percutaheous transluminal coronary artery stenting, and they were also compared with those of 18 normal subjects. [Results] Brachial artery flow-mediated vascular dilation （FMD） of the resenotic and non-restenotic group before stent implantation were significantly lower than that of the normal subjects （2.4±4.2） % and （22.6±6.4）% vs （25.9±5.2）% （P〈0.05）, 16 of 67 cases （23.9%） were found restenosis after 6 months of stent implantation. There was no statistical difference in FMD between restenotic and non-restenotic groups before stent implantation （P 〉0.05）. In the group of restenosis, however, FMD was decreased markedly after 6 months of stent implantation （18.4±3.9）% in comparision with before stent implantation, nevertheless, there was no significant change before and after 6 months of stent implantation in non-restenotic group （22.6±.4）% and （21.9±6.9）%. [Conclusion] Endothelium dependent dilation of the group of restenosis was significantly decreased after 6 months of stent implantation. Some measures should be taken to protect and to restore the endothelial function. Non-invasive ultrasonic detection of brachial FMD may be a helpful method to predict restenosis after coronary stent implantation.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2005年第18期2792-2794,共3页
China Journal of Modern Medicine
关键词
经皮冠状动脉支架术
再狭窄
肱动脉流量介导舒张
内皮功能
percutaneous transluminal coronary stenting
restenosis
bmchial flow-mediated dilation
endothelialfunction
