冠状动脉支架置入术后再狭窄与内皮功能关系的临床分析

A comparative analysis of endothelial function in patients with restenosis after coronary stent implantation

目的观察血管内皮功能失调与冠心病支架置入术后再狭窄的关系。方法在支架术后6个月随访的患者中选择11例再狭窄及15例非狭窄病例,采用高分辨率超声检测两组患者肱动脉血流介导的内皮依赖性血管扩张百分比(FMD),比较两组患者的内皮功能。结果两组基础肱动脉内径(D1)差异无统计学意义,再狭窄组的反应性充血时肱动脉内径(D2)小于非再狭窄组[(4.26±0.10)mm和(4.42±0.12)mm,t=-3.59,P=0.001],再狭窄组的肱动脉内径变化绝对值(ΔD)小于非再狭窄组[(0.23±0.09)mm和(0.34±0.11)mm,t=-2.83,P=0.009],再狭窄组FMD低于非再狭窄组(5.74±2.17和8.48±2.80,t=-2.70,P=0.013)。FMD与再狭窄的偏相关系数为0.47(t=0.04)。结论冠状动脉支架置入术后再狭窄患者的内皮功能较非再狭窄患者明显减退,血管内皮功能异常与支架置入术后的再狭窄有相关性。

Objective To evaluate the correlation of endothelial dysfunction with restenosis after coronary stent implantation. Methods 26 patients who underwent coronary stenting were divided into 2 groups according to the presence（n=11 ） or absence （n= 15 ） of in-stentt restenosis 6 months after the procedure. All patients underwent ultrasound assessment of brachial artery /low-mediated dilation. Results The baseline value （D1） of brachial artery diameter in both groups showed no difference. The postocclusion value （D2） and absolute diameter change （AD） of brachial artery in restenosis group were smaller than those of non-restenosis group [ （4.26±0.10）mm vs （ 4.42 ±0.12 ）mm,t=-3.59 ,P=0.001, （0.23±0.09）mm vs （ 0.34 ±0.11）mm,t=-2.83,P=0.009 ,respectively ]. The percent diameter variation（FMD） was lower in restenosis group compared with that of non-restenosis group（5.74± 2.17 vs 8.48±2.80,t=-2.70,P=0.013）.The partial correlation coefficient of FMD and restenosis was 0.47 （t= 0.04）. Conclusion The endothelial dysfunction was more obvious in patients with restenosis compared with those without restenosis after coronary stent implantation. There was a correlation between endothelial dysfunction and restenosis.