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目的:探讨稳定性心绞痛患者经皮冠状动脉(冠脉)介入治疗(PCI)术中的炎症反应及其意义。方法:回顾性分析78例稳定性冠心病患者临床资料,根据术后6个月左右行冠脉造影复查后分为再狭窄组(10例)及无再狭窄组(68例),分析其在PCI术前、术后即刻、术后24h、术后72h及复查冠脉造影前的超敏C反应蛋白(hs-CRP)、血管细胞黏附分子-1(VCAM-1)、细胞间黏附分子-1(ICAM-1)水平。结果:PCI术后所有患者hs-CRP、VCAM-1水平与术前相比均明显升高,且再狭窄组患者术后72hhs-CRP[(9.81±4.76)mg/dl∶(6.64±2.89)mg/dl,P<0.05]高于无再狭窄组;术后24h时再狭窄组hs-CRP水平高于无再狭窄组[(3.77±1.52)mg/dl∶(2.43±1.05)mg/dl,P<0.05];两组ICAM-1水平在PCI术前、术后即刻、术后24h及术后72h均差异无统计学意义,但在术后72h时,再狭窄组ICAM-1水平与术前相比明显增高[(7.23±3.46)ng/ml∶(4.35±2.07)ng/ml,P<0.05]。结论:稳定性心绞痛患者PCI术后24h、72h时hs-CRP、VCAM-1明显增高提示患者可能出现支架内再狭窄;术后72hICAM-1水平较术前明显增高提示支架内再狭窄发生概率较高。
Objective: To investigate the inflammatory reaction and its significance in percutaneous coronary intervention (PCI) in patients with stable angina. Methods: The clinical data of 78 patients with stable coronary heart disease were retrospectively analyzed. According to the coronary angiography at 6 months after operation, they were divided into two groups: restenosis group (n = 10) and no restenosis group (n = 68) The serum levels of hs-CRP, VCAM-1, ICAM-1 and CRP were measured before PCI, immediately after PCI, at 24h, 72h after PCI and before PCI. 1 (ICAM-1) level. Results: The levels of hs-CRP and VCAM-1 in all patients after PCI were significantly higher than those before surgery, and the values of 72hhs-CRP [(9.81 ± 4.76) mg / dl: (6.64 ± 2.89) mg / dl, P <0.05] higher than that in the group without restenosis; The level of hs-CRP in restenosis group was higher than that in the group without restenosis [(3.77 ± 1.52) mg / dl , P <0.05]. There was no significant difference in ICAM-1 levels between the two groups before PCI, immediately after PCI, 24h after PCI and 72h after PCI, but at 72h after PCI, (7.23 ± 3.46) ng / ml: (4.35 ± 2.07) ng / ml, P <0.05]. Conclusions: The hs-CRP and VCAM-1 levels in patients with stable angina pectoris at 24 h and 72 h after PCI are significantly higher than those in patients with stable angina pectoris, suggesting that the patients may have restenosis. The ICAM-1 levels at 72 h after operation are significantly higher than those before operation, suggesting that the incidence of in-stent restenosis high.