巨细胞病毒感染与冠状动脉支架新生内膜组织量的关系

Relationship between cytomegalovirus infection and coronary inner stent neointimal proliferation

目的探讨巨细胞病毒感染与冠状动脉支架内新生内膜增生的相关性,为其临床研究提供可参考依据。方法采用回顾性研究方法收集2010年1月-2012年12月175例入住心内科冠心病患者临床资料,所有患者根据病情均给予冠状动脉支架置入术,且均于术后6个月再次行冠状动脉造影剂血管超声检查;采用酶联免疫吸附法对抗人巨细胞病毒IgG抗体进行测定,分析巨细胞病毒感染与新生内膜增生的相关性。结果 175例行冠状动脉支架置入术治疗的患者中有85例患者抗人巨细胞病毒IgG抗体阳性,阳性率48.6%;抗人巨细胞病毒IgG抗体阳性患者术前、后最小腔内直径及术后腔径增大与阴性患者比较差异无统计学意义;而阳性患者术后6个月最小腔内直径明显低于阴性患者,阳性患者术后6个月腔径减小明显低于阴性患者,差异均有统计学意义(P<0.05);同时阳性患者再狭窄21例占24.7%,阴性患者再狭窄10例占11.1%,比较差异有统计学意义(χ2=5.54,P<0.05)。结论巨细胞病毒感染与冠状动脉支架新生内膜增生存在密切的相关性,其可能增加内膜增生发生的风险,在临床工作中对于该类患者需要积极进行必要的干预措施,可能降低再狭窄的发生。

OBJECTIVE To explore the relationship between ther cytomegalovirus （CMV） infection and the coronary inner stent neointimal proliferation so as to provide reterence for clinical study. METHODS By means of retrospective survey, the clinical data were collected from 175 coronary heart disease patients who were hospitalized the department of cardiology from Jan 2010 to Dec 2012, then all the patients received the coronary stent implantation according to the condition, 6 months later, the intravascular ultrasound examination was performed with of coronary angiography agent, the enzyme-linked immunosorbent assay was employed to determine the IgG antibody against CMV, the correlation between the CMV infection and the neointimal proliferation was analyzed. RESULTS Of totally 175 patients who underwent the coronary stent implantation, 85 patiemts were tested positive for the IgG antibody with 48. 6 % of the positive of rate; the difference the preoperative or postoperative minimum lumen diameter or the increase of postoperative lumen diameter between the IgG antibody-positive patients and the IgG antibody-negative patients was not statistically significant. Six monhs later, the minimum lumen diameter of the IgG positive patients was significantly lower than that of the IgG negative patients; the decrease in the lumen diameter was significantly lower in the IgG positive patients than in the IgG negative patients, with statistical significance （P〈0.05）. There were 21 （24.7%） cases of restenosis among the IgG positive patients and 10 01. 1%） cases among the IgG negative patients, the difference was statistically significant （x^2 =5. 54,P〈0. 05）. CONCLUSION There is a close correlation between the CMV infection and the coronary artery stent neointimal hyperplasia, which may increase the risk of endometrial hyperplasia; it is necessary to take targeted intervention measures in the clinical work so as to reduce the incidence of restenosis.