摘要
目的联合检测急诊经皮冠状动脉介入治疗(PCI)前后血清血管内皮生长因子(VEGF)及高敏C反应蛋白(hs-CRP)水平变化,旨在探讨急诊PCI术前后血清VEGF及hs-CRP水平变化与急诊PCI术后再狭窄的关系。方法检测100例急诊PCI的ST段抬高型心肌梗死(STEMI)患者术前、术后3天、术后7天血清中VEGF、hs-CRP水平,根据6个月随访冠状动脉造影结果分为再狭窄组和无再狭窄组,分析急诊PCI术后3天和术后7天血清VEGF及hs-CRP变化水平与术后再狭窄的关系。结果急诊PCI术前血清VEGF水平高于术后3天和7天水平(P<0.01);急诊PCI术前血清hs-CRP水平低于术后3天水平,而高于术后7天水平(P<0.01)。再狭窄组急诊PCI术前血清VEGF水平显著低于无再狭窄组(P<0.05);术后3天血清VEGF水平与无再狭窄组无明显差别(P>0.05);术后7天血清VEGF水平与无再狭窄组无明显差别(P>0.05);术后3天血清VEGF下降幅度明显低于无再狭窄组(P<0.05)。再狭窄组急诊PCI术前血清hs-CPR水平与无再狭窄组无差别(P>0.05);术后3天血清hsCRP水平与无再狭窄组无明显差别(P>0.05);术后7天血清hs-CPR水平与无再狭窄组无明显差别(P>0.05);术后3天血清hs-CPR升高幅度明显高于无再狭窄组(P<0.05)。急诊PCI术后3天血清VEGF下降幅度与急诊PCI术后支架再狭窄呈负相关(rs=-0.411,P<0.05);术后3天血清hs-CPR升高幅度与急诊PCI术后支架再狭窄呈正相关(rs=0.414,P<0.05)。结论急诊PCI术后3天血清VEGF及hs-CRP变化水平与急诊PCI术后再狭窄高度相关,联合检测急诊PCI术后3天血清VEGF下降的幅度及术后3天血清hs-CRP升高的幅度,或可成为预测急诊PCI术后再狭窄的生化指标。
Objective To explore the relationship between stent restenosis and the changes of serum vascular endothelial growth factor （VEGF）,high sensitive C-reactive protein （hs-CRP）levels after emergency percutaneous coronary intervention（PCI）in patients with ST-elevation myocardial infarction（STEMI）.Methods Serum VEGF and hs-CRP levels in 100 patients with STEMI were determined before,3d and 7d after emergency PCI.Enzyme-linked immunosorbent assay was used to detect serum VEGF and immune turbidimetric method was used to detect serum hs-CRP.According to the result of coronary angiography during the follow-up period,the patients were divided into restenosis and non-restenosis group.The correlation of the changes of serum VEGF and hs-CRP levels with stent restenosis was analyzed.Results Serum VEGF level was significantly reduced at 3 d and 7 d after emergency PCI （P〈0.01）,while serum hs-CRP level increased at 3 d after emergency PCI but decreased at 7 d after emergency PCI （P〈0.01 ）.Serum VEGF level before emergency PCI in restenosis group was remarkably lower than that in non-restenosis group （P 〈0.05）,while it showed no statistical difference between restenosis and non-restenosis groups at 3 d and 7 d after emergency PCI （P 〉0.05,respectively）.The declining range of serum VEGF at 3 d after emergency PCI in the restenosis group was significantly lower than that in the non-restenosis group （P 〈0.05 ）.There was no statistical difference in serum hs-CRP level before,3 d and 7 d after emergency PCI between restenosis and non-restenosis groups （P 〉0.05,respectively）,but the increasing range of serum hs-CRP at 3 d after emergency PCI in the restenosis group was significantly higher than that in the non-restenosis group （P 〈0.05）.The declining range of serum VEGF at 3 d after emergency PCI was negatively correlated with stent restenosis （r s =0.41 1,P 〈0.01）,while the increasing range of serum hs-CRP at 3 d after emergency PCI was positively correlated with stent res
出处
《临床荟萃》
CAS
2014年第11期1217-1221,共5页
Clinical Focus
关键词
冠心病
心肌梗死
血管内皮生长因子类
C反应蛋白质
血管成形术
冠状动脉
冠状动脉再狭窄
coronary disease
myocardial infarction
vascular endothelial growth factors
C-reactive protein
angioplasty,balloon,coronary
coronary restenosis
