经皮冠状动脉介入术对冠状动脉微循环的影响

Effects of Percutaneous Coronary Intervention in Coronary Artery Microcirculation

目的 分析经皮冠状动脉介入治疗术对冠状动脉微循环的影响.方法 回顾性分析2013年1月～2014年12月本院收治的130例冠心病患者临床资料,患者均予以经皮冠状动脉介入术治疗,对比患者手术前后冠状动脉微循环阻力指数（IMR）与高敏C-反应蛋白水平（hs-CRP）.结果 患者经皮冠状动脉球囊扩张（PTCA）及支架植入后IMR水平均高于术前,差异均有统计学意义（p＜0.05）,但PTCA后与支架植入后无明显差异（p＞0.05）;患者的股动脉、冠状窦hs-CRP水平在PTCA后与支架植入后均明显升高,前后对比差异有统计学意义（p＜0.05）.结论 经皮冠状动脉介入治疗术可致冠心病患者术后IMR与hs-CRP水平升高,考虑与手术器械压迫冠状动脉血管壁致动脉粥样硬化斑块破裂及血管内皮损伤相关,从而导致冠状动脉的微循环障碍与炎症反应.

Objective To explore the effects of percutaneous coronary intervention in coronary artery microeirculation. Methods The clinical data of 130 patients with coronary heart disease who had received treatment in our hospital between January 2013 and December 2014 were reviewed, which were given pereutaneous coronary intervention for treatment. The index of microcirculatory resistance （IMR） and high- sensitivity C-reactive protein （hs-CRP） were compared. Results After percutaneous transluminal coronary angioplasty （PTCA） and stent implantation, the level of IMR was shown to be higher than before the surgery, with statistically significant difference （p 〈0.05）, but no significant difference was shown between those undergone PTCA and stent implantation （p〉0.05）. The hs-CRP levels of arteria cruralis and coronary sinus were increased after PTCA and stent implantation, with statistically significant difference compared with those before treatment （p 〈0.05）. Conclusion Percutaneous coronary intervention may cause the level of IMR and hs-CRP to increase, which is considered to be associated with the atheroselerotic plaque rupture or vascular endothelial injury from the pressure of operation instrument on the coronary arterial vascular wall, thus leading to coronary microcirculation dysfunction and inflammation.