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目的:探讨血清白细胞介素-18(IL-18)、氧化低密度脂蛋白(ox-LDL)与急诊经皮冠状动脉介入治疗(PCI)术后支架内再狭窄的关系。方法:75例急性心梗急诊介入术后8～12个月内接受冠状动脉造影复查,其中9例有再狭窄作为再狭窄组,66例无再狭窄作为对照组。2组术后均接受阿司匹林、氯吡格雷、他汀类等药物治疗。取2组患者PCI术前、术后冠状动脉造影复查时血清标本,采用酶联免疫吸附法(EL ISA)检测血清IL-18、ox-LDL水平。结果:①再狭窄组PCI术后IL-18、ox-LDL水平较术前均明显升高[(2.37±0.22):(0.85±0.19)mg/L、(6.99±0.98):(2.38±1.06)mg/L],均P<0.01;对照组PCI后IL-18、ox-LDL水平较术前明显下降[(0.48±0.11):(1.23±0.09)mg/L、(1.39±0.54):(4.45±0.87)mg/L],P<0.05。②再狭窄组和对照组PCI术前IL-18、ox-LDL水平差异无统计学意义,再狭窄组PCI术后IL-18、ox-LDL水平显著高于对照组(均P<0.01)。④再狭窄组和对照组术前、术后IL-18和ox-LDL水平均呈正相关。结论:PCI术后再狭窄患者血浆IL-18及ox-LDL水平明显升高,二者可作为PCI术后再狭窄的预测指标。
Objective: To investigate the relationship between serum interleukin-18 (IL-18), ox-LDL and in-stent restenosis after emergency percutaneous coronary intervention (PCI). Methods: A total of 75 acute myocardial infarction patients underwent emergency coronary intervention within 8-12 months after coronary angiography. Among them, 9 patients had restenosis as restenosis group and 66 patients without restenosis as control group. Two groups were treated with aspirin, clopidogrel, statins and other drugs. Serum samples were taken from two groups of patients before and after coronary angiography. Serum levels of IL-18 and ox-LDL were measured by enzyme-linked immunosorbent assay (ELISA). Results: ① The levels of IL-18 and ox-LDL in the restenosis group were significantly higher than those before PCI [(2.37 ± 0.22) :( 0.85 ± 0.19) mg / L, (6.99 ± 0.98) :( 2.38 ± 1.06 ) (P <0.01). The levels of IL-18 and ox-LDL in the control group after PCI were significantly lower than those before the operation [(0.48 ± 0.11) :( 1.23 ± 0.09) mg / L, (4.45 ± 0.87) mg / L], P <0.05. ② The levels of IL-18 and ox-LDL in restenosis group and control group before PCI were not significantly different. The levels of IL-18 and ox-LDL in restenosis group were significantly higher than those in control group after PCI (all P <0.01). ④ The levels of IL-18 and ox-LDL in restenosis group and control group were positively correlated before and after surgery. Conclusion: The levels of IL-18 and ox-LDL in patients with restenosis after PCI are obviously increased, both of which can be used as predictors of restenosis after PCI.