童国新,王宁夫,张邢炜,李佩璋,徐坚,凌峰,吴桂萍,金建芬,周亮,叶显华,杨建敏,潘浩

• 1: 杭州市第一人民医院心内科
• 2:杭州市第一人民医院心内科
• 3:杭州市第一人民医院心内科
• 4:杭州市第一人民医院心内科

摘要(Abstract)：

目的探讨不稳定型心绞痛患者经皮冠状动脉介入治疗(PCI)术中分别静脉应用普通肝素或低分子肝素对血浆肝细胞生长因子(HGF)的影响。方法74例不稳定型心绞痛患者根据PCI术时使用肝素类型分为普通肝素组(49例)和低分子肝素组(25例),分别在术前、术中、术后即刻以ELISA法测定外周血HGF的水平。结果两组术前HGF水平差异无统计学意义。普通肝素组和低分子肝素组术中及术后即刻HGF水平与术前相比均显著升高(术后中与术前比较:普通肝素组为12322.19±3723.31ng/L比1736.09±603.95ng/L,P<0.00001;低分子肝素组为9141.31±2521.91ng/L比1675.28±630.53ng/L,P<0.00001。术后即刻与术前HGF水平比较:普通肝素组为13565.60±3768.99ng/L比1736.09±603.95ng/L,P<0.00001;低分子肝素组为10092.35±2723.00ng/L比1675.28±630.53ng/L,P<0.00001)。低分子肝素组在PCI术中和术后即刻两个不同时段其外周血HGF水平均低于普通肝素组(P均<0.01)。结论不稳定型心绞痛患者在PCI术中无论是应用普通肝素还是低分子肝素,均可促进外周血HGF的释放,但在PCI术手术过程中,静脉注射普通肝素升高外周血HGF的作用比低分子肝素更强。

关键词(KeyWords)： 冠状动脉疾病;肝细胞生长因子;血管成形术,经腔,经皮冠状动脉;肝素

Abstract:

Keywords:

基金项目(Foundation): 浙江省医药卫生科学研究基金(2004B163);; 市医药卫生科技重点项目(2003J003)

作者(Author): 童国新,王宁夫,张邢炜,李佩璋,徐坚,凌峰,吴桂萍,金建芬,周亮,叶显华,杨建敏,潘浩

参考文献(References)：

• [1]Nakagami H,Morishita R,Yamamoto K,et al.Mitogenic and antiapoptotic actions of hepatocyte growth factor through ERK,STAT3,and AKTin endothelial cells.Hypertension,2001,37:581-586.
• [2]Nakagami H,Morishita R,Yamamoto K,et al.Anti-apoptotic action of hepatocyte growth factor through mitogen-activated pro-tein kinase on human aortic endothelial cells.J Hypertens,2000,18:1411-1420.
• [3]Heeschen C,Dimmeler S,Hamm CW,et al.Prognostic Signifi-cance of Angiogenic Growth Factor Serum Levels in Patients With Acute Coronary Syndromes.Circulation,2003,107:524-530.
• [4]Susen S,Sautiere K,Mouquet F,et al.Serum hepatocyte growth factor levels predict long-term clinical outcome after percutaneous coronary revascularization.Eur Heart J,2005,26:2387-2395.
• [5]Salbach PB,Bruckmann M,Turovets O,et al.Heparin-mediated selective release of hepatocyte growth factor in humans.Br J Clin Pharmacol,2000,50:221-226.
• [6]中华医学会心血管病学分会.中华心血管病杂志编辑委员会.不稳定型心绞痛诊断和治疗建议.中华心血管病杂志,2000,6:409-412.
• [7]Bhatt DL,Lee BI,Casterella PJ,et al.Safety of concomitant thera-py with eptifibatide and enoxaparin in patients undergoing percu-taneous coronary intervention:results of the coronary revascular-ization using integrilin and single bolus enoxaparin study.J Am Coll Cardiol,2003,41:20-25.
• [8]Galeote G,Hussein M,Sobrino N,et al.Use of enoxaparin or un-fractionated heparin and abciximab during percutaneous coronary interventions:a randomized pilot study.Rev Esp Cardiol,2002,55:1261-1266.
• [9]Matsumori A,Ono K,Okada M,et al.Immediate increase in cir-culating hepatocyte growth factor/scatter factor by heparin.J Mol Cell Cardiol,1998,30:2145-2149.
• [10]Naka D,Ishii T,Shimomura T,et al.Heparin modulates the re-ceptor-binding and mitogenic activity of hepatocytegrowth factor on hepatocytes.Exp Cell Res,1993,209:317-324.
• [11]Moreno E,Meneu JC,Calvo J,et al.Modulation of hepatocyte growth factor plasma levels in relation to the dose of exogenous heparin administered:an experimental study in rats.Transplant Proc,2005,37:3943-3947.
• [12]Sato T,Yoshinouchi T,Sugimoto T,et al.Prognostic value of se-rum hepatocyte growth factor in patients with acute coronary syn-dromes.Jpn Circ J,1999,63:583-588.
• [13]Matsumoto K,Tajima H,Okazaki H,et al.Heparin as an in-ducer of hepatocyte growth factor.J Biochem(Tokyo),1993,114:820-826.
• [14]Yasuda S,Goto Y,Baba T,et al.Enhanced secretion of cardiac hepatocyte growth factor from an infarct region is associated with less severe ventricular enlargement and improved cardiac func-tion.J Am Coll Cardiol,2000,36:115-121.
• [15]Nakamura T,Mizuno S,Matsumoto K,et al.Myocardial protec-tion from ischemia/reperfusion injury by endogenous and exoge-nous HGF.J Clin Invest,2000,106:1511-1519.
• [16]Ahmet I,Sawa Y,Yamaguchi T,et al.Gene transfer of hepato-cyte growth factor improves angiogenesis and function of chronic ischemic myocardium in canine heart.Ann Thorac Surg,2003,75:1283-1287.