摘要
背景:支架再狭窄是支架置入后血管壁受牵张和损伤引起炎症性愈合反应为特征的病理过程。炎症细胞在支架再狭窄中起了重要作用,针对这些炎性细胞是防治支架再狭窄的最佳选择,调节炎症反应可减少支架再狭窄。目的:观察冠状动脉支架置入前后急性冠脉综合征患者炎症指标高敏C-反应蛋白、补体C3质量浓度的变化,分析冠状动脉支架置入后炎症反应与支架再狭窄的关系。设计、时间及地点:对比观察,于2005-12/2009-05在邢台市人民医院心内科完成。对象:纳入邢台市人民医院心内科收治的急性冠脉综合征行冠心病支架置入治疗的病例65例。方法:65例急性冠脉综合征患者根据冠状动脉造影结果,行冠状动脉支架置入治疗,根据病变置入国产雷帕霉素药物洗脱支架——Firebird支架。主要观察指标:支架置入前常规查血常规,置入6个月后复查冠状动脉血管造影。分别于支架置入前、支架置入后48h、6个月取肘静脉血,检测高敏C-反应蛋白、补体C3质量浓度。结果:65例患者中56例完成随访,临床再狭窄率为9%(5/56)。支架置入后48h外周静脉血高敏C-反应蛋白、补体C3质量浓度均显著高于支架置入前(P<0.05),支架置入后6个月显著低于支架置入后48h(P<0.05)。与非支架再狭窄组患者相比,支架再狭窄组支架置入前白细胞数、中性粒细胞百分比、高敏C-反应蛋白、补体C3质量浓度明显增高(P<0.05),支架置入后48h静脉血中高敏C-反应蛋白、补体C3质量浓度明显增高(P<0.05)。结论:支架再狭窄与炎症反应有关,雷帕霉素支架抑制支架再狭窄。
BACKGROUND： Stent restenosis is a pathological process characterized by inflammatory healing response. Inflammatory cells play an important role in stent restenosis, thus, it can be controlled to reduce stent restenosis. OBJECTIVE： To observe the changes of high-sensitivity C-reactive protein （hs-CRP） and complement C3 before and after coronary stent implantation in patients with acute coronary syndrome, and to study the relation of inflammatory reactions and stent restenosis. DESIGN, TIME AND SETTING： A contrast observation was performed at the Department of Cardiology, People＇s Hospital of Xingtai between December 2005 and May 2009. PARTICIPANTS： A total of 65 patients with acute coronary syndrome and treated by percutaneous transluminal coronary intervention were collected. METHODS： According to coronary anglography, sirolimus-eluting stent （Firebird stent） was selected and implanted to cure acute coronary syndrome. MAIN OUTCOME MEASURES： Blood routine examination was performed before stent implantation and coronary anglography were used over a 6-month follow-up. The hs-CRP and complement C3 concentration was detected prior to, 48 hours and 6 months after operation. RESULTS： Fifty-six patients were followed up, and the restenosis rate was 9% （5/56）. The levels of hs-CRP, complement C3 in peripheral vein blood was obviously higher at 48 hours after implantation than prior to operation （P 〈 0.05）, which was lower at the 6 months after implantation （P 〈 0.05）. Compared to the no stent restenosis, the concentrations of white blood cell counts, neutrophit percent, hs-CRP, and complement C3 were notably increased after stent implantation （P 〈 0.05）. The patients with stent restenosis had higher levels of hs-CRP and complement C3 at 48 hours than those of no stent restenosis （P 〈 0.05）. CONCLUSION： The stent restenosis is related to inflammatory reactions. The sirolimus-eluting stent can inhibit stent restenosis.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第43期8446-8449,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
