摘要
目的初步探讨PCI后血清脂联素水平与内皮功能因子、炎症因子变化特点,以及左旋氨氯地平作用对ISR的影响。方法对我院行冠状动脉支架植入术成功的58例冠心病患者作为研究对象。入选患者随机分为两组:对照组(基础用药,n=27例)、左旋氨氯地平组(基础用药+左旋氨氯地平n=31例)。检测患者术前及术后6个月的APN、Hs-CRP、ET-1和一氧化氮(NO)水平变化,分析APN与各内皮因子间的相关性,并观察CAG结果及术后患者主要不良心脏事件,评价不同药物治疗对冠脉支架植入术后支架内再狭窄的影响。结果①两组术后血TC、TG、LDL-c水平与基线相比下降(P值均为<0.05)、HDL-c相比则升高(P<0.05)。②两组术后Hs-CRP、ET-1水平均较术前下降(P值均为<0.05),而NO、APN水平均较术前上升(P值均为<0.05);术后左旋氨氯地平组Hs-CRP、ET-1水平低于对照组(P值均为<0.05),而术后左旋氨氯地平组NO、APN水平高于对照组(P值均为<0.05)。③APN与TC、TG、LDL-c、Hs-CRP、ET-1呈负相关,而与HDL-c、NO呈正相关。④左旋氨氯地平组心血管不良事件发生率低于对照组,但与对照组相比,无显著性差异。结论冠脉支架植入术后患者升高的APN水平与APN上升、NO升高、ET-1降低、以及Hs-CRP水平降低有关,左旋氨氯地平的干预有助于APN的提升,可能在拮抗ISR机制和降低心血管不良事件中起积极的作用。
[ Objective ] To study the serum adiponctin level and its correlation with markers of inflammation and endothelial function in patients after percutaneous transluminal coronary intervention （PCI）, and the effect of Levam- lodipine on in-stent restenosis （ISR）. [Methods ] The subjects were 58 patients with successful percutaneous trans- luminal coronary intervention in coronary heart disease which were randomly divided into control group （routine treatment, n =27） and Levamlodipine group （routine treatment＋Levamlodipine, n =31）. Serum APN （Adiponectin）, high sensitivity C-reactive protein （Hs-CPR）, Endothelin-1 （ET-1） and Nitric oxide （NO） were measured before and 6 months after PCI. Correlation of APN with other factors was analyzed. The main adverse cardiac events were deter- mined and effects of different treatments on ISR were evaluated by coronary angiography. [ Results ] TC, TG, LDL-c were decreased significantly in 6 months compared to baseline in both groups （P 〈0.05, P 〈0.05, P 〈0.05 respec- tively）, while HDL-c was increased （P 〈0.05）. Hs-CRP, ET-1 were decreased in 6 months than baseline （P 〈0.05, P 〈0.05 respectively）, while NO, APN were increased （P 〈0.05, P 〈0.05 respectively）. In 6 mouths, Hs-CRP and ET- 1 were shown lower levels in group Levamlodipine than those in control （P 〈0.05, P 〈0.05 respectively）, whereas NO, APN were higher in group Levamlodipine （P 〈0.05, P 〈0.05 respectively）. APN was negatively correlated to TC, TG, LDL-c, Hs-CRP and ET-I, while was positively correlated to HDL-c and NO. The tendency of cardiovascular adverse events was lower in group Levamlodipine than that of control, but not significantly（P 〉0.05）. [ Conclusions ]The intervention of Levamlodipine resulted in increasing APN which correlated to the elevation of APN, NO and de- crease of ET-1, Hs-CRP. The elevation of APN might involve in reduction of adverse cardiac events and ISR.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2013年第27期35-39,共5页
China Journal of Modern Medicine
基金
广东省科技计划资助项目(No:2011B080701073)
