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目的研究直接冠状动脉支架植入术与常规冠状动脉支架植入术前后血清白细胞介素-6(IL-6)、C反应蛋白(CRP)水平的变化并探讨支架术后早期炎性反应的机制及与远期临床再狭窄的关系。方法选择我院2003年10月~2004年12月成功接受常规冠脉内支架治疗的患者(A组)和直接冠状动脉支架植入术的患者(B组)各25例,均为单一支架植入者。分别于支架术前、术后6h、48h、7d留取外周血,检验血清CRP值,另-20℃冷冻保存血清,择期检测血清IL-6,观察指标进行统计学分析。结果A组和B组术后6小时IL-6和术后48hCRP均较术前显著升高(P<0.001);两组术后7天IL-6、CRP与术前比较均无显著性差异(P>0.05);B组术后IL-6、CRP峰值与A组比较均显著降低(P<0.001);随访6个月,A组与B组的再狭窄率相比为21.1%vs9.1%(P>0.05)。结论IL-6、CRP可作为支架术后的炎性标志物;直接冠状动脉支架植入术具有较高的即刻成功率和安全性,再狭窄率有明显降低趋势。
Objective To investigate the changes of serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels before and after coronary artery stenting and conventional coronary stent implantation and to investigate the early inflammatory response Mechanism and its relationship with long-term clinical restenosis. Methods Twenty-five patients (A group) and patients undergoing direct coronary stent implantation (B group) were enrolled in our hospital from October 2003 to December 2004, all of whom were single stent-graft Enter. Peripheral blood was collected before operation, 6h, 48h, 7d after operation. Serum CRP level was measured. Serum was also stored frozen at -20 ℃. Serum IL-6 level was measured by echocardiography. Statistical analysis was performed. Results The levels of IL-6 and postoperative 48 h CRP in group A and group B were significantly higher than those before operation (P <0.001). No significant difference was found in IL-6 and CRP between the two groups (P> 0.05). The peak of IL-6 and CRP in group B was significantly lower than that in group A (P <0.001). After 6 months of follow-up, the restenosis rate in group A and group B was 21.1% vs9. 1% (P> 0.05). Conclusions IL-6 and CRP can be used as inflammatory markers after stenting. Direct coronary stent implantation has a high immediate success rate and safety, and the rate of restenosis is obviously decreased.