MCP-1在脑动脉支架植入术围术期及随访期间的炎症研究

The Inflammatory Response of MCP-1 in Patients with Cerebral Stent Implantation During Perioperative and Follow-up Periods

目的以脑血管支架植入患者为研究对象,通过ELISA方法探讨单核细胞趋化蛋白-1(MCP-1)在围术期及随访期间的表达,进一步了解MCP-1在支架植入术后的炎症免疫反应过程。方法筛选50例该中心给予脑血管支架植入的患者,另有30例同期住院未接受支架术治疗的同病患者为对照组。签署知情同意书后,分别在两组患者术前、术后7 d和术后6个月,用ELISA检测其相关炎性细胞因子MCP-1的表达水平。结果与对照组比较,支架治疗患者外周血中MCP-1水平在术前分布接近(P>0.05),在术后7 d和术后6个月明显升高(P<0.01)。支架治疗组患者术后6个月经影像学检查证实发生再狭窄患者16例(32%),其血清MCP-1水平分布在术前和术后7 d与支架术后无再狭窄患者接近(P>0.05),但术后6个月MCP-1水平显著高于后者(P<0.01)。结论血浆MCP-1的表达增高可能参与了脑血管支架植入后引发的局部和系统的急性炎症反应,且指标随访期间高表达是支架术后再狭窄的危险因素。

Objective To explore the expression of monocyte chemoattractant protein-1（MCP-1） in patients with cerebral stent implantation during perioperative and follow-up periods by ELISA so as to further investigate the inflammation immune response process of MCP-1 after stent implantation. Methods 50 cases underwent cerebral stent implantation in our center were enrolled as the investigating subjects, another 30 subjects had the same disease hospitalized during the same period without accepting stenting were considered as the control group. And the informed consent was signed in both groups. Then, the expression levels of inflammatory cytokine MCP-1 were measured by ELISA before operation, 7 days and 6 months after operation in the two groups. Results The contents of MCP-1 in peripheral blood of the stent group were similar to the control group before angiography or catheterization（P〉0.05）, but significantly higher than those of the control group 7 days and 6 months after stent insertion（P〈0.01）. Among 50 patients of the stent group, 16 cases had restenosis 6 months after operation confirmed by imaging examination（32%）, the contents of serum MCP-1 of the patients were similar to those without restenosis in stages before angiography or catheterization and 7 days after stent insertion（P〉0.05）, but significantly higher than that of the cases without restenosis 6 months after stent insertion（P〈0.01）. Conclusion The increase of the expression of MCP-1 in plasma may involve in the local and systematic acute inflammatory reaction due to cerebral stent implantation, and the high expression level of MCP-1 in the follow-up period is the risk factor of poststent restenosis.