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目的:观察冠状动脉支架置入术后早期血管损伤的变化情况,探讨冠状动脉支架置入术后再狭窄的机制。方法:选择经冠状动脉造影检查证实为冠心病的患者,随机分为支架组(30例)及对照组(30例)。2组患者均于冠状动脉支架置入或冠状动脉造影术前后采集肘静脉血,检测内皮素-1(ET-1)、P-选择素(PS)、纤维蛋白原(Fbg)、CD11b的水平,并进行统计学分析。结果:①支架组中ET-1、PS在术后0.5h上升至高峰,Fbg、CD11b在术后1d达到高峰;与术前当天及对照组比较,均差异有统计学意义(P<0.01)。②术前水平与术后高峰的差值在ET-1、Fbg、CD11b两两之间呈正相关,年龄及支架长度与ET、Fbg、CD11b术后高峰水平之间无相关性。结论:支架置入术后早期出现了明显的血管损伤反应,伴随着显著的血小板活化及一过性的凝血功能亢进,并诱发了明显的局部炎症反应。
Objective: To observe the changes of early vascular injury after coronary stent implantation and to explore the mechanism of restenosis after coronary stent implantation. Methods: Patients who had coronary artery disease confirmed by coronary angiography were randomly divided into three groups: stent group (30 cases) and control group (30 cases). The elbow venous blood was collected before and after coronary stent implantation or coronary angiography in both groups. The levels of ET-1, PS, Fbg, CD11b Level, and statistical analysis. Results: ① The levels of ET-1 and PS in the stent group increased to the peak at 0.5h after operation, and the peak of Fbg and CD11b peaked on the 1st day after operation. Compared with the preoperative day and the control group, the difference was statistically significant (P0.01) . There was a positive correlation between the preoperative level and postoperative peak in any pair of ET-1, Fbg and CD11b. There was no correlation between age and stent length and the postoperative peak levels of ET, Fbg and CD11b. CONCLUSIONS: There was a clear vascular injury response early after stenting, accompanied by significant platelet activation and transient hyperthyroidism and a clear local inflammatory response.