磁化冠状动脉内支架置入术后冠状静脉窦血管活性物质的动态变化及作用机制研究

Effects of intracoronary magnetized stent placement on level changes of NO, ET-1 and SOD in coronary sinus of patients with coronary heart disease

目的 探讨冠心病患者冠状动脉 (冠脉 )内磁化支架置入术后冠状静脉窦血中一氧化氮 (NO)、内皮素 1(ET 1)及超氧化物歧化酶 (SOD)等血管活性物质的动态变化及作用机制。方法 39例心绞痛患者分为磁化支架 (MS)组 2 3例 ,非磁化支架 (NMS)组 16例。各例于PTCA术球囊首次扩张前、以及术后的即刻、1小时、3小时、6小时取冠状静脉窦血 ,测定血清NO ,血浆ET 1及SOD。结果 MS组术后 6小时内冠状静脉窦血中ET 1水平的变化不如NMS组明显 ,MS组NO含量较NMS组显著升高 ,MS组SOD较NMS组升高。结论 ( 1)MS明显减少术中ET 1释放与术后合成。 ( 2 )MS明显增加术后NO生成的速度和量。 ( 3)MS使SOD活力增强 ,有利于清除活性氧介质 ,减轻支架置入后缺血 /再灌注造成的损伤。

Objectives Our study aimed to investigate the effects of magnetized stent on serum NO, plasma ET-1 and superoxide dismutase (SOD) in coronary sinus in patients undergoing PTCA and ICSP. Methods All 39 patients had angiographically significant coronary artery disease, which was over 75 percent diameter stenosis of at least one epicardial artery. According to the types of stents implanted, the patients were devided into two groups: non-magnetized stent(NMS)and magnetized stent(MS)groups. Blood samples were collected during the first 6 hours after PTCA and ICSP to determine the above variables. Results Serum levels of NO and SOD of MS group were significantly higher than those of NMS, while plasma levels of ET-1 didn' t change as markedly as those of NMS. Conclusions (1)MS reduced the release of ET-1 during PTCA and the synthesis after ICSP.(2)MS increased the speed and amount of NO production after ICSP. (3)MS promoted the activities of SOD significantly in favor of removing ROI and thus contributed to reducing I/R injury after ICSP.