冠心病患者冠状动脉药物洗脱支架植入前后血浆骨膜蛋白水平的变化

Change of plasma periostin level after coronary stent implantation

目的通过比较冠心病患者药物洗脱支架植入前后血浆骨膜蛋白(POSTN)水平的变化,研究其与介入治疗的关系,进一步探讨其在冠心病患者中发挥的作用。方法连续入选从2013年10月28日-2014年2月5日在北京大学第一医院心内科就诊并行介入治疗的冠心病患者,签署知情同意书,收集其临床资料和介入手术情况,采集其介入治疗前和介入治疗后第1天及第3天的血样标本,测定POSTN的浓度,比较介入治疗前后变化情况。结果共入选资料完整的冠心病患者130例。介入治疗后血浆POSTN水平较术前明显降低[术后3 d vs.术后1 d vs.术前:(1.68±0.63)vs.(2.36±0.95)vs.(2.70±1.25)ng/ml,P<0.001)],冠脉造影1 d后血浆POSTN水平亦较术前降低[(2.49±1.35)vs.(3.23±1.20)ng/ml,P<0.001)]。结论冠心病患者冠脉造影及介入治疗后血浆POSTN水平降低,可能与涂层药物及他汀抗炎抗增殖和其他炎症因子的相互作用相关。

【Objectives】 To evaluate the change of periostin after drug-eluting stent（DES） implantation.【Methods】We selected 130 coronary heart disease（CHD） patients who were implanted DES. The periostin level was measured before, 1 day and 3 days after the procedure. Changes of this biomarker were observed and compared between different time points. 【Results】The periostin decreased significantly at 1 day after percutaneous coronary intervention（PCI） compared with baseline [（2.36±0.95） vs.（2.70±1.25） ng/ml, P〈0.001）] and there was a further decline of periostin at 3 days after PCI compared with that at 1 day [（1.68±0.63） vs.（2.36±0.95） ng/ml, P〈0.001]. The periostin also decreased significantly after coronary angiography（CAG） [（2.49 ±1.35） vs.（3.23 ±1.20） ng/ml, P〈0.001]. 【Conclusion】The level of periostin decreased after CAG and PCI, which may be associated with the antiproliferative coated drugs, statins and interaction between other inflammatory factors.