不稳定心绞痛患者不同冠状动脉病变PCI术后炎症因子的变化及意义

Changes of inflammatory factors after PCI in unstable angina patients with different types of coronary lesions

目的 探讨不稳定心绞痛患者不同类型冠状动脉病变经皮冠状动脉介入治疗（PCI）后炎症因子的变化及临床意义.方法 选取经冠状动脉造影证实的118例不稳定心绞痛患者,根据检查结果分为钙化斑块组（47例）、不稳定斑块组（37例）及稳定斑块组（34例）.所有患者于手术当天及术后24h清晨采集空腹血2ml进行血清超敏C反应蛋白（hs-CRP）、TNF-α及血小板源生长因子（PDGF）水平的测定.结果 3组患者术前血清hs-CRP、TNF-α及PDGF水平的差异均无统计学意义（均P＞0.05）,而术后血清hs-CRP、TNF-α及PDGF水平均较术前显著增加（均P〈0.01）;而且术后钙化斑块组及不稳定斑块组患者血清hs-CRP水平较稳定斑块组显著增加（P〈0.01）.结论 不稳定心绞痛患者PCI术后hs-CRP、TNF-α及PDGF水平均较术前明显升高,而不稳定斑块及钙化斑块患者术后升高更为显著.因此对于不稳定斑块及钙化斑块患者术后应加强干预治疗,预防术后的炎症反应,防止支架内血栓形成.

Objective To investigate the changes of inflammatory factors and its clinical significance in unstable angina patients with different type of coronary artery lesion after percutaneous coronary intervention （PCI）. Methods One hundred and eighteen patients with unstable angina were enrolled in the study, including patients with stable plaque （n=34）, vulnerable plaque （n=37） and calcified plaque （n=47）. Serum levels of hs-CRP, TNF- α and PDGF were measured before and after PCI. Results There were no significant differences in serum hs-CRP,TNF-α and PDGF levels among three groups before PCI; however, serum hs-CRP,TNF-α and PDGF levels were significantly increased after PCI. And hs-CRP was markedly increased in patients with vulnerable and calcium plaque. Conclusion Results suggest that for patients with vulnerable and calcium plaque intensive inventions should be taken to prevent inflammation and thrombosis after PCI.