血清白细胞介素-18、氧化低密度脂蛋白与急性心肌梗死患者急诊PCI术后支架内再狭窄的关系

Relationship between plasma level of IL-18,ox-LDL and the development of emergency percutaneous coronary intervention

目的:探讨血清白细胞介素-18(IL-18)、氧化低密度脂蛋白(ox-LDL)与急诊经皮冠状动脉介入治疗(PCI)术后支架内再狭窄的关系。方法:75例急性心梗急诊介入术后8～12个月内接受冠状动脉造影复查,其中9例有再狭窄作为再狭窄组,66例无再狭窄作为对照组。2组术后均接受阿司匹林、氯吡格雷、他汀类等药物治疗。取2组患者PCI术前、术后冠状动脉造影复查时血清标本,采用酶联免疫吸附法(EL ISA)检测血清IL-18、ox-LDL水平。结果:①再狭窄组PCI术后IL-18、ox-LDL水平较术前均明显升高[(2.37±0.22):(0.85±0.19)mg/L、(6.99±0.98):(2.38±1.06)mg/L],均P<0.01;对照组PCI后IL-18、ox-LDL水平较术前明显下降[(0.48±0.11):(1.23±0.09)mg/L、(1.39±0.54):(4.45±0.87)mg/L],P<0.05。②再狭窄组和对照组PCI术前IL-18、ox-LDL水平差异无统计学意义,再狭窄组PCI术后IL-18、ox-LDL水平显著高于对照组(均P<0.01)。④再狭窄组和对照组术前、术后IL-18和ox-LDL水平均呈正相关。结论:PCI术后再狭窄患者血浆IL-18及ox-LDL水平明显升高,二者可作为PCI术后再狭窄的预测指标。

Objective： To investigate the relationship between serum level of interleukin-18,oxidized low density lipoprotein（ox-LDL） and the development of in stent restenosis after emergency percutaneous coronary intervention.Method： A total of seven-ty-five patients with successfully coronary stent implantation followed by coronary angiography within 8-12 months after emergency PCI were enrolled.patients with restenosis（n = 9） were assigned in restenosis group,and 66 patients in control group.Blood serum levels of IL-18 and ox-LDL were analysed in all cases before PCI and after PCI within 8-12 months.Blood serum IL-18,ox-LDL were mea-sured by ELISA.Result： Blood serum levels of IL-18 and ox-LDL were significantly higher than those before PCI in restenosis group（P0.01）.The biomarkers were significantly lower than those before PCI in control group（P0.01）.There was no significantly difference of IL-18 and ox-LDL levels between restenosis group and control group before PCI,but they were significantly higher in restenosis group than incont rol group after PCI（P0.01）.There was a positive correlation between serum levels of IL-18 and ox-LDL in restenosis group as well as in control group before and after PCI.Conclusion： Both IL-18 and ox-LDL may be regarded as prognostic indicators in patients developing restenosis af ter coronary stenting.