转化生长因子β1对冠状动脉支架术后再狭窄的预测价值

Prediction of transforming growth factor β1 for in-stent restenosis in patients with coronary artery disease after percutaneous coronary intervention procedure

目的探讨血清转化生长因子β1(TGF-β1)对冠心病患者经皮冠脉介入术(PCI)后再狭窄的意义。方法对74例PCI术后患者进行冠状动脉造影及光学相干断层成像(OCT)检查,依据冠状动脉造影结果分为再狭窄组和非再狭窄组,比较两组内膜组织覆盖厚度、最狭窄处血管管腔面积、最狭窄处支架面积等,计算支架的最大内膜组织覆盖面积(NA)及支架的内膜组织覆盖面积百分比;术前1天、术后24小时、术后7天、术后6个月行血清TGF-β1检测,并比较PCI前后及两组间差异。结果与非再狭窄组比较,再狭窄组的内膜组织覆盖厚度、内膜组织覆盖面积增加,最小管腔面积减小。与术前比较,再狭窄组、非再狭窄组术后24小时、7天及6个月TGF-β1含量显著升高(P<0.01)。与非再狭窄组比较,术后24小时、7天及6个月再狭窄组的TGF-β1含量显著升高(P<0.01),术后6个月时两组间差异无统计学意义。再狭窄组患者术后的内膜组织覆盖面积百分比与TGF-β1呈显著正相关。结论 PCI术后24小时、7天时TGF-β1含量可作为预测冠脉支架术后再狭窄的参考指标。

Objective To discuss the significance of transforming growth factorβ1（TGF-β1）for in-stent restenosis（ISR）in patients with coronary disease after percutaneous coronary intervention（PCI）.Methods PCI procedure was carried out in 74 patients with coronary disease in the hospital.After the procedure,both coronary angiography and optical coherence tomography（OCT） were conducted.According to the results of coronary angiography,the patients were divided into ISR group and non-ISR group.The maximal neointimal hyperplasia thickness of stent,minimal lumen area（LA）,stent cross-sectional area,the neointimal hyperplasia area,the percentage of the area of the neointimal,diameter stenosis ratio were measured and calculated,respectively.The serum TGF-β1level was detected 1day before PCI,24 hours,7days and 6months after PCI.TGF-β1levels after PCI in each group were compared.Results Compared with non-ISR group,both neointimal hyperplasia thickness and area in ISR group were increased significantly.Compared with pre-PCI,the concentration of TGF-β1in both ISR group and nonISR group were significantly increased 24 hours,7days and 6months after PCI（P〈0.01）.The concentration of TGF-β1at 24 hours 7days and 6months after PCI in ISR group were obviously higher than those in non-ISR group（P〈0.01）.The percentage of the area of the neointimal was positively correlated to TGF-β1.Conclusion The concentration of TGF-β1at 24 hours and 7days after PCI bears close relationship to the restenosis degree.