巴曲酶对CAS术后早期炎性反应干预的观察

Effects of batroxobin on early inflammatory reaction after CAS

目的通过测定循环炎性介质白介素-6(IL-6)和高敏C反应蛋白(hs-CRP)水平,观察巴曲酶能否降低颈动脉支架成形术(CAS)后炎症反应的程度。方法选择实施单侧颈动脉支架置入术的患者40例,随机分成2组,治疗组和对照组各20例。治疗组患者常规服用阿司匹林及波立维,术前24h一次性给予巴曲酶10BU治疗,术中一次性给予5BU,并在术中用5BU巴曲酶(5～10ml生理盐水稀释)浸泡支架和输送系统。对照组仅常规服用阿司匹林及波立维,不采用巴曲酶治疗。在CAS术前、术后6h和24h抽取静脉血,测定血清IL-6和CRP水平。结果治疗组和对照组术后6h和24hIL-6水平和术后24hhs-CRP水平较术前显著升高(P<0.05)。组间比较发现治疗组CAS术后6、24h的IL-6和术后24h的hs-CRP循环水平低于对照组(P<0.05)。结论巴曲酶治疗组较对照组有较低的炎症反应水平,提示巴曲酶对颈动脉支架术后的炎症反应有一定的抑制作用,对预防颈动脉支架术后炎症反应引起的再狭窄可能有潜在治疗价值。

Objective To investigate whether batroxobin depresses inflammations reaction due to the injury of CAS appliances by detecting serum IL-6 and C-reactive protein（CRP）. Methods A total of 40 patients, who presented CAS indications,were divided averagely to control and subject groups randomly. Both of them were treated regularly with aspirin and clopidogrel. Patients in subject group were administered 10 Bu batroxobin less than 24 hours before the procedure, and 5 Bu during the procedure. The appliances for subject group were also flushed with normal saline adding batroxobin（SBu/ 5-10ml） during the operation. Circulating serum IL-6 and CRP levels were measured before （H0）, 6 hours （H6）and 24 hours （ H24 ） following CAS. Results Circulating serum IL-6 （ H0, H24） and CRP （H24） levels following the procedure were statistically higher than before that （H0） in both groups （ P 〈 0.05 ）. Serum IL-6 （ H6, H24） and CRP （ H24 ） levels after the procedure in control group were also statistically elevated than in subject group（ P 〈 0.05 ）. Conclusion The study presents a lower level of inflammatory reaction by way of degrading fibrinogen with batroxobin. Batroxobin may play a potential role in depressing the regional inflammation evoked by the injury of appliances to avoid a higher risk of restenosis.