经皮冠状动脉介入术对冠心病患者血清同型半胱氨酸及半乳糖血凝素-3的影响与病情相关性分析

Influence of percutaneous coronary intervention on homocysteine and galection-3 in serum of patients with coronary heart disease and correlation analysis

目的探讨经皮冠状动脉介入(PCI)术对冠心病患者血清同型半胱氨酸(Hcy)及半乳糖血凝素-3(Galectin-3)的影响与病情相关性分析。方法选择2016年9月至2017年10月在济南市中心医院心内科行冠脉造影的冠心病患者70例,依照造影情况分为观察组47例:A型病变组25例,B型病变组22例,均置入涂有药物的支架;对照组23例:冠脉造影提示无需行PCI术。分别于手术前1d、术后1d和7d测定各组血浆Hcy、脑钠肽(BNP)及血清Galectin-3的浓度。追踪PCI术后患者,随访1年,观察血清Hcy及Galectin-3水平变化与冠心病的严重程度的相关性。结果PCI术后A组血Hcy浓度[(16.52±5.41)μmol/L]和B组血Hcy浓度[(19.32±6.35)μmol/L]较术前[(11.66±3.25)μmol/L、(15.87±5.20)μmol/L]均明显升高(t=2.375,P<0.05;t=2.97,P<0.01);同时术后A组血Galectin-3浓度[(0.86±0.11)μg/L]和B组血Galectin-3浓度[(1.15±0.48)μg/L]较术前[(0.32±0.53)μg/L、(0.46±0.19)μg/L]均升高(t=2.178,P<0.05;t=4.269,P<0.01);血清Hcy及Galectin-3的水平与冠心病严重程度呈正相关。结论血清Hcy及Galectin-3浓度于PCI术后较前明显升高,说明术中球囊对血管扩张和斑块挤压破坏,影响了Hcy、Galectin-3的上调及表达。血Hcy、Galectin-3水平对冠心病的诊断和病变程度的评价有一定的帮助。

Objective To discuss the influence of percutaneous coronary intervention(PCI) on the serum concentration of homocysteine(Hcy) and galectin-3 in patients with coronary heart disease(CHD). Methods From September 2016 to October 2017,70 patients in Ji'nan Central Hospital were selected.According to the results of coronary angiography(CAG),they were divided into observation group with drug-eluted stents(n=47,including 25 cases with type A CHD and 22 cases with type B CHD) and control group without abnormal CAG(n=23).Serial venous blood samples were obtained 1 day before PCI as well as 1 day and 7 days after PCI.Plasma concentrations of Hcy,BNP and galectin-3 were measured and compared.The postoperative patients with PCI were tracked for 1 year to observe the influence of serum Hcy and galectin-3 on the severity of CHD and the quality after PCI. Results The plasma Hcy levels of type A[(16.52±5.41)μmol/L]and type B[(19.32±6.35)μmol/L]after PCI were significantly higher than those of the type A[(11.66±3.25)μmol/L]and the type B[(15.87±5.20)μmol/L]before PCI(t=2.375,P<0.05,t=2.97,P<0.01).Meanwhile,the plasma galectin-3 levels of type A[(0.86±0.11)μg/L] and type B[(1.15±0.48)μg/L]after PCI were also higher than those of the type A[(0.32±0.53)μg/L]and the type B[(0.46±0.19)μg/L]before PCI(t=2.178,P<0.05,t=4.269,P<0.01).Furthermore,levels of the plasma Hcy and galectin-3 were positively associated with the severity of CHD. Conclusion The higher blood levels of serum Hcy,BNP and galectin-3 after PCI indicate that the balloon inflation and implantation of stent can affect the level of plasma Hcy,BNP and galectin-3.Therefore,the levels of serum Hcy and galectin-3 are helpful to diagnose CHD and evaluate the degree of CHD.