冠心病单支病变经皮冠状动脉介入治疗术前后血清血管内皮生长因子水平变化

Changes of serum vascular endothelial growth factor level before and after percutaneous coronary intervention in patients with single-vessel disease

目的探讨冠心病(coronary heart disease,CHD)患者经皮冠状动脉介入治疗(percutaneous coronaryintervention,PCI)前后血清中血管内皮生长因子(vascular endothelial growth factor,VEGF)水平的变化。方法选取52例CHD患者作为实验组,男30例,女22例,年龄30～78岁,平均(63.5±9.4)岁,冠状动脉造影证实为冠状动脉单支病变(累及左前降支或右冠状动脉或左回旋支),分别检测PCI术前、术后40分钟、术后7天血清中VEGF的水平,并选取50例冠状动脉造影证实冠状动脉血管完全正常者作为对照组,男20例,女30例,年龄25～78岁,平均(61.3±8.3)岁,分别检测冠状动脉造影前、后40分钟、造影后7天血清中VEGF的水平。两组间性别、年龄、吸烟、高血压、高血脂、糖尿病等差异无统计学意义。进而分析比较两组血清VEGF水平变化。结果实验组外周血中术前VEGF水平明显高于对照组术前水平,(521.18±38.11)ng/L vs(322.24±31.88)ng/L,且实验组PCI术后40分钟VEGF水平显著高于其术前水平,(521.18±38.11)ng/L vs(584.81±53.35)ng/L,PCI术后7天血清中VEGF水平明显下降至低于PCI术前水平,(521.18±38.11)ng/L vs(497.14±49.74)ng/L。对照组冠状动脉造影前后40分钟及造影后7天,血清VEGF水平无明显变化。结论血清VEGF水平可早期灵敏反映PCI术后冠状动脉血管内皮损伤、再内皮化过程及血运重建情况,或可成为反映冠状动脉缺血、缺氧的重要指标。

Objective To observe the changes of serum vascular endothelial growth factor（VEGF） level before and after pereutaneous coronary intervention （PCI） on coronary heart disease （CHD） patients. Methods The experimental group included 52 CHD patients, who had been confirmed to be single-vessel disease （involved the left anterior descending coronary artery, right coronary artery or left circumflex artery） by coronary angiography. The male patients 30 eases,female patients 22 cases,age 30-78 years old,average （63.54±9.4） years old. We detected the serum VEGF levels respectively before PCI,40 minutes and 7 day after the PCI. Meanwhile, the control group consisted of 50 normal subjects,their serum VEGF levels were tested respectively before coronary angiography, 40 minutes and 7 day after coronary angiography. The male 20 cases,female 30 cases,age 25-78 years old,average （61.3±8.3） years old. The gender, age, smoking, high blood pressure ,.high cholesterol and diabetes between two groups showed no statistical significance. Then,we compared and analyzed the results of VEGF. Results The VEGF level of experimental group was significantly higher than that of control group before coronary angiography, （ 521. 18 ± 38.11） ng/L vs （ 322.24± 31.88） ng/L. The VEGF level of experimental group increased significantly 40 minutes after PCI, （521. 18±38. 11） ng/L vs （584. 81± 53.35） ng/L, but VEGF decreased obviously 7 days after PC1 compared with that before PCI, （521. 18±38.11） ng/L vs （497. 14±49.74） ng/L. The serum VEGF levels before coronary angiography,40 minutes and 7 day after the PCI in control group did not show significant change. Conclusion The serum VEGF level may become an important indicator of coronary ischemia and anoxia, and can reflect coronary endothelial injury, reendothelialization process and coronary artery recanalization after PCI early and sensitively.