血浆P-选择素和内皮素-1预测冠状动脉内支架术后早期再狭窄的价值The study on prognostic value of plasma endothelin 1 and P-selectin in early in-stent restenosis
苏子德,代怀静,王涛,刘跃森,侯子龙,蔡庆岭
摘要(Abstract)：
目的探讨急性冠状动脉综合征(ACS)患者经皮介入治疗(PCI)术后血浆P-选择素及内皮素-1(ET-1)的动态变化对预测术后发生支架内再狭窄的价值。方法对108例行PCI手术的ACS患者,分别于术前和术后即刻、1周、2周、1个月、3个月、6个月采集外周静脉血,4℃离心分离血浆,-70℃保存备测。所有患者术后6个月常规行冠状动脉(冠脉)造影(CAG)。根据冠脉造影结果分为冠脉再狭窄组和无再狭窄组,并分析两组血浆P-选择素及ET-1的水平。结果随访中4例患者死亡,均为急诊PCI患者,4例失访,余100例根据冠脉造影结果分为冠脉再狭窄组(n=16)和无再狭窄组(n=84)。两组ACS患者血浆P-选择素及ET-1在术后即刻达高峰,较术前明显增加,冠脉无再狭窄组术后24h恢复至术前水平,2周降至正常,术后1个月、3个月、6个月在正常基线范围内上、下波动。冠脉再狭窄组血浆P-选择素和ET-1术后2周没有降至正常,而呈持续性升高,并在术后3~6个月出现第2次高峰,与无再狭窄组相比差异有统计学意义。结论ACS患者PCI术后早期(1~2周)P-选择素及ET-1持续升高,并在术后3~6个月出现第2次高峰,则冠脉发生再狭窄的危险性高。P-选择素及ET-1可作为预测早期冠脉再狭窄的参考指标。
关键词(KeyWords)： 冠状动脉疾病;血管成形术,经腔,经皮冠状动脉;支架;内皮缩血管肽-1;P选择素
基金项目(Foundation): 山东省卫生厅科研基金资助(2003HW019)
作者(Author): 苏子德,代怀静,王涛,刘跃森,侯子龙,蔡庆岭
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