经皮冠状动脉介入治疗对急性心肌梗死患者血清血管内皮生长因子、高敏C反应蛋白及纤维蛋白原的影响

Effect of Percutaneous Coronary Intervention on Blood Levels of Vascular Endothelial Growth Factor, High Sensitivity C-reactive Protein and Fibrinogen in Patients With Acute Myocardial Infarction

目的:探讨经皮冠状动脉介入治疗(PCI)对急性心肌梗死(AMI)患者血清血管内皮生长因子(VEGF)、高敏C反应蛋白(hs-CRP)及纤维蛋白原(Fg)的影响。方法:选择110例行PCI的AMI患者为AMI组,53例健康体检人员为对照组,比较AMI患者PCI术前及术后(术后30 min、24 h、72 h)血清VEGF、hs-CRP、Fg水平的变化,以及PCI术后AMI患者发生心脏不良事件(MACE)患者与无MACE发生患者24 h峰值血清VEGF、hs-CRP及Fg水平的变化。结果:(1)与对照组比较,AMI组术前、术后30 min、24 h、72 h血清VEGF(pg/ml,130.5±40.2、143.2±49.7、107.1±31.8、97.3±24.4 vs 84.7±21.4)、hs-CRP(mg/L,3.11±0.56、4.67±0.62、6.42±0.72、2.83±0.56 vs 1.03±0.34)、Fg(mg/L,4.79±0.52、5.02±0.54、5.54±0.67、4.11±0.44 vs 3.86±0.32)水平均升高,差异均有统计学意义(P均<0.05);与AMI组术前比较,AMI组术后30 min、24 h、72 h血清VEGF先升高(峰值在术后30 min),后逐渐降低;而血清hs-CRP、Fg逐渐升高(峰值在术后24 h),后降低,差异均有统计学意义(P均<0.05)。(2)AMI患者术后24 h出现MACE者38例,无MACE者72例。与无MACE者比较,MACE者术后24 h血清VEGF(pg/ml,155.5±42.8 vs131.7±36.5)、hs-CRP(mg/L,6.89±0.53 vs 5.68±0.62)及Fg(mg/L,5.66±0.55 vs 5.23±0.60)均升高,差异均有统计学意义(P均<0.01)。结论:血清VEGF、hs-CRP及Fg水平的监测对PCI术后AMI患者有重要的临床应用价值。

Objective： To study the effects of percutaneous coronary intervention（PCI） on blood levels of vascular endothelial growth factor（VEGF）, high sensitivity C-reaction protein（hs-CRP） and fibrinogen（Fg） in patients with acute myocardial infarction（AMI）.Methods： Our research included 2 groups： AMI group, n=110 patients with PCI and Control group, n=53 healthy subjects from physical examination. Blood levels of VEGF, hs-CRP and Fg were compared between pre-operation and 30 min, 24 h, 72 h post-operation; the peak values of VEGF, hs-CRP and Fg were compared between the patients with post-operative MACE occurrence at 24 h and the patients without MACE occurrence.Results：（1） Compared with Control group, blood levels of VEGF, hs-CRP and Fg in AMI group were increased at pre-operation and 30 min, 24 h, 72 h post-operation, for VEGF（pg/ml） as（84.7±21.4） vs（130.5±40.2） and（143.2±49.7）,（107.1±31.8）,（97.3±24.4）; for hs-CRP（mg/L） as（1.03±0.34） vs（3.11±0.56） and（4.67±0.62）,（6.42±0.72）,（2.83±0.56）; for Fg（mg/L） as（3.86±0.32） vs（4.79±0.52） and（5.02±0.54）,（5.54±0.67）,（4.11±0.44） respectively, all P〈0.05. In AMI group, the post-operative value of VEGF was first increased, it reached the peak at 30 min and then gradually decreasing; while hs-CRPand Fg were increased gradually, they reached the peak values at 24 h time point, all P〈0.05.（2） In AMI group, compared with the patients without post-operative MACE（72/110）, the patients with MACE（38） had elevated 24 h post-operative levels of VEGF as（131.7±36.5 vs 155.5±42.8）, hs-CRP as（5.68±0.62 vs 6.89±0.53） and Fg as（5.23±0.60 vs 5.66±0.55） respectively, all P〈0.01.Conclusion： Post-operative monitoring of blood levels of VEGF, hs-CRP and Fg had the important clinical value in AMI patients after PCI.