经皮冠状动脉介入治疗前后血清ox-LDL的变化及其临床意义

Changes of oxidized low density lipoprotein levels before and after percutaneous coronary intervention

目的研究经皮冠状动脉介入(PCI)治疗前后血清氧化低密度脂蛋白(ox-LDL)水平的变化情况及其临床意义。方法133例冠心病(CHD)患者根据行PCI与否分为干预组80例及未干预组53例。两组患者均于入院后空腹抽取静脉血,行冠状动脉造影(CAG)或PCI后即刻及PCI术后2 d留取静脉血,检查血脂及ox-LDL水平。结果干预组PCI术后ox-LDL水平(86.92±32.85)mg/L较术前(75.38±27.36)mg/L明显升高(P<0.01),其升高程度在冠状动脉狭窄严重、急性心肌梗死(AMI)及不稳定心绞痛(UA)患者中呈上升趋势,并于术后2 d回到术前水平;未干预组则无明显变化。结论CHD患者PCI术后ox-LDL水平可出现短暂升高,提示可能与介入所致粥样斑块破损有关。

Objective To study the changes of the oxidized low density lipoprntein （ox-LDL） levels before and after percutaneous coronary intervention （ PCI）, and clarify the clinical significance of ox-LDL. Methods One hundred and thirty three patients with coronary heart disease （CHD） were divided into PCI （80） and non-PCI （53） groups. Fasting plasmas of before coronary angiography （CAG） , plasmas immediate after CAG or PCI, and two days after PCI were collected, and the levels of ox-LDL and other lipids were detected. Results The level of ox-LDL in PCI group immediate after PCI was significantly higher than that before PCI [ （86.9 ±32.9） mg/L vs （75.4 ±27.4） mg/L, P 〈0.01 ] , and the extent of the increased level was higher in patients with severe stenosis, AMI, and UA. The level of ox-LDL two days after PCI dropped to the level of before PCI. The ox-LDL level before and after CAG in non-PCI group showed no difference. Conclusion The level of ox-LDL transiently increased markedly after PCI in patients with CHD, which might imply the relation with rapture of atheromatous plaque by intervention.