急性冠脉综合征国产药物支架置入患者血清hs-CRP、sICAM-1和sFas的变化及意义

Changes of serum hs-CRP,sICAM-1 and sFas of patients with acute coronary syndrome after domestic drug eluting stent implantation and it's clinical significance

目的探讨急性冠脉综合征(ACS)国产药物支架置入患者血清高敏C反应蛋白(hs-CRP)、可溶性细胞间黏附分子-1(sICAM-1)和可溶性细胞凋亡因子(sFas)的变化及意义。方法ACS患者55例分为PCI国产药物支架置入35例(观察组)和单纯冠状动脉造影(CAG)检查20例(对照组),分别测定两组术前、术后1 d和术后3 d血清hs-CRP、sICAM-1、sFas含量变化。结果观察组术后1 d血清hs-CRP、sICAM-1、sFas含量较术前升高(P均<0.01),术后3 d hs-CRP及sICAM-1较术后1 d升高(P均<0.01)。观察组和对照组血清hs-CRP、sICAM-1、sFas含量在术前无统计学差异(P>0.05),而观察组术后1 d和术后3 d以上三者含量都明显高于对照组(P<0.01)。血清hs-CRP、sICAM-1和sFas三者之间呈正相关(r=0.272、0.456、0.537,P均<0.05)。结论国产药物支架置入术可能短时间内触发及加重炎症反应,支架置入患者体内存在动脉内膜平滑肌细胞过度增殖和凋亡不足。

Objective To evaluate the changes of the hs-CRP, sICAM-1 and sFas of patients with acute coronary syndrome（ACS） after domestic drug eluting stent implantation and to discuss the significance of clinical treatment. Methods 55 patients with ACS were divided into two groups, 35 patients treated with PCI（ observation group） and 20 patients with CAG （comparison group）. The contents of hs-CRP, sICAM-1 and sFas in blood serum of patients were detected preoperation and postoperation on first day and on third day. Results One day after PCI, the contents of hs-CRPs,sICAM-1 and sFas were significantly increased（P 〈0.01 ）. hs-CRP and slCAM-1 increased significantly 3 days after PCI compared with those of one day after PCI（ P 〈 0.01 ）. As for the contents of these three elements, there were no statistics significance between two groups before operation （ P 〉 0.05 ）, after one day or 3 days of PCI, these three dements in the observation group were much higher than those in the comparison group （ all P 〈 0.01 ）. These three elements correlated positively（ r = 0. 272, 0.456, 0.537 ; all P 〈 0.05）. Conclusions PCI may trigger and aggravate inflammatory reaction at a very short time and the phenomena of vascular smooth muscle cell proliferation and deficient apoptosis exists after PCI.