叶酸预防药物涂层支架内再狭窄的研究

Reserch of folic acid′s prevention to the in-stent restenosis of drug-eluting stent

目的研究叶酸对药物涂层支架(DES)内再狭窄(ISR)的预防作用。方法DES支架术后患者随机分为叶酸(FA)组和对照组,叶酸组加服叶酸5mg/d。检测并对比两组支架术后即刻、术后6个月、术后1年血FA和同型半胱氨酸(Hcy)。两组患者于术后即刻和1年后行冠脉造影检查以测定并对比最小病变血管内径。结果两组患者大部分基线指标差异无统计学意义。叶酸组患者腰围较对照组高(P<0.01),低密度脂蛋白(LDC-C)较对照组低(P<0.05)。两组间术后即刻叶酸浓度、tHcy浓度和最小病变血管直径无统计学意义(P>0.05)。术后6个月和术后1年叶酸组患者叶酸浓度较对照组升高(P<0.05),tHcy浓度较对照组降低(P<0.05)。术后1年叶酸组最小病变血管直径较对照组大(P<0.05)。结论叶酸可以预防药物涂层支架内再狭窄。

Objective Research the prevention of folic acid （FA） to the in-stent restenosis （ISR） of drug-eluting stem （DES）. Methods 107 patients that after implanted DES were divided into the group of taking FA and non taking FA. The serum FA and the plasma homocysteine（Hcy） of two groups were measured when immediately after implanted stent, after implanted stent 6 mouths and 1 year. The minimum coronary artery diameter were measured by coronary angiograms when immediately after implanted stent and after implanted stent 1 year. Results Patients were well-matched with no significant differenced at baseline in majority measured parameters between two groups. The waistline of the groups that taking FA were significantly higher than the group non taking FA （P〈0.01 ）, and the low density lipoprotein-eholesterol（LDC-C） were lower than non taking FA（ P〈0.05）, The serum FA, Hey and the minimum coronary artery diameter of two groups were matched with no significant differenced when immediately after implanted stem（P〉0. 05 ）. The serum FA of taking FA group were higher than non taking（ P〈0. 05 ） and the Hey were lower than non taking （P〈0. 05 ） when after implanted stent 6 mouths and 1 year. The minimum coronary artery diameter of taking FA group were bigger than non taking （ P〈0.05 ） when after implanted stent 1 year. Conclusion The results showed that FA has preventive effect on the ISR of DES.