冠心病患者PCI术前后血清AFABP的变化及意义

Changes and significance of serum AFABP with preoperative and postoperative of PCI in patients with coronary heart disease

目的测定冠状动脉粥样硬化性心脏病(冠心病)患者PCI术前后脂肪细胞型脂肪酸结合蛋白(AFABP)及白介素-6(IL-6)的变化,探讨二者的规律及潜在联系。方法收集山西医科大学第一医院心内科66例行冠脉介入证实为冠心病的病例,根据其临床特征分为3个临床亚组:急性心肌梗死(AMI)组23例、不稳定型心绞痛(UAP)组21例、稳定性心绞痛(SAP)组22例;同时根据Gensini积分将纳入的冠心病患者分为轻度、中度、重度冠状动脉(冠脉)硬化亚组,选取20例冠脉造影证实无病变的患者作为对照组,受试者分别于入院次日(或术前)及术后次日晨空腹取肘静脉血,检测AFABP及IL-6。结果与对照组相比,冠心病各临床亚组患者血清AFABP、IL-6水平均增高,AMI组血清AFABP、IL-6较其余两组明显升高,而轻、中、重度冠状动脉硬化组间差异有统计学意义,随着冠脉硬化程度加重,血清AFABP、IL-6逐渐升高;除正常对照组外,各组患者血清AFABP、IL-6水平术后均降低,差异具有统计学意义;手术前后血清AFABP与IL-6有明显相关性。结论 AFABP与IL-6联合可能更好的反映冠状动脉的炎症状态,可用于评估冠脉狭窄程度及冠心病患者的长期随访,尤其是PCI术后患者。

Objective To determine the changes of adipocyte fatty acid binding protein(AFABP)and interleukin-6(IL-6)with preoperative and postoperative of PCI in patients with coronary heart disease.Methods According to the clinical features,66 coronary artery patients were enrolled and divided into acute myocardial infarction(AMI)group(n=23),unstable angina(UAP)group(n=21)and stability angina(SAP)group(n=22).According to Gensini,the subjects were divided into mild,moderate,and severe coronary artery subgroups.A total of 20 patients with coronary angiography were selected as the control group.The subjects were taken from the hospital the next day(or before the operation)and the next day after the operation,and the AFABP and IL-6 were detected.Results Compared with the control group,the serum AFABP and il-6 levels were increased in all groups.The serum AFABP and il-6 of the AMI group were significantly higher than those of the other two groups.The differences between mild,moderate and severe coronary stenosis were statistically significant.Except the normal control group,the serum AFABP and il-6 levels of the postoperative patients in each group decreased,and the difference was statistically significant.There was significant correlation between serum AFABP and IL-6 before and after surgery.Conclusion The AFABP association with IL-6 may better reflect the inflammatory state of the coronary artery,which can be used to assess the degree of coronary stenosis and long-term follow-up of patients with coronary heart disease,especially postoperative patients with PCI.