冠状动脉再次血运重建患者血清对氧磷酶-1的活性研究

Serum paraoxonase-1 activity in patients undergoing repeat coronary revascularizations

目的了解血清对氧磷酶-1活性水平对再次冠状动脉血运重建的预测价值。方法以比色法测定200例行经皮冠状动脉介入治疗获得完全血运重建患者的血清对氧磷酶-1活性水平。术后随访1年,在首次介入手术后第6个月进行造影随访。将随访期内需要再次血运重建的患者归入再次血运重建组,无需再次血运重建的患者归入单次血运重建组,同期冠状动脉造影排除冠状动脉粥样硬化性心脏病(冠心病)患者100例作为非冠心病对照组。分析各组血清对氧磷酶-1活性水平的差异。结果再次血运重建组62例,单次血运重建组138例。所有患者均完成1年随访,6个月冠状动脉造影复查率88.5%(177/200),12个月造影复查率69%(138/200)。再次血运重建组、单次血运重建组、非冠心病组的血清对氧磷酶-1活性水平值分别为(109.2±98.6)μkat/L、(132.8±79.4)μkat/L、(156.4±82.8)μkat/L,方差分析示3组血清对氧磷酶-1活性水平差异有统计学意义(P<0.05)。结论冠心病再次血运重建组血清对氧磷酶-1活性水平低于单次血运重建组和非冠心病对照组,故血清对氧磷酶-1活性水平对预测RCR有重要的价值。

Objectives To illuminate the value of paraoxonase-1 （PON 1 ） in predicting repeat coronary revascularization （RCR）. Methods Serum PON1 activity of 200 patients who had achieved complete revascularizations in first percutaneous coronary intervention （PCI） was determined by colorimetric method. All patients received one-year follow- up. Coronary angiographies were performed in the 6th month after first procedures. Patients who need more revascularization procedures during follow-up were enrolled in RCR group, those who did not need were enrolled in single coronary revascularization （SCR） group. One hundred patients with normal coronary angiography results during the same period were included in non-coronary heart disease control group （NCC）. Serum PON1 activity of the 3 groups was analyzed and compared. Results Sixty two patients were enrolled in RCR group and 138 patients in SCR group. All patients finished one-year follow-up. Proportion of patients who received coronary artery angiography after follow-up for 6 months was 88.5%（177/200）, and that of 12 months was 69%（138/200）. Serum PON1 activities in RCR group, SCR group and NCC group were （ 109.2 ±98.6 ） μkat/L, （ 132.8 ±79.4） μkat/L and （ 156.4±82.8 ） μkat/L, respectively. Statistic differences were found among three groups （P〈0.05）. Conclusions Serum PON-1 activity is lower in patients who need RCR than in patients need SCR or without coronary heart disease, and thus it may be valuable to predict RCR.