CAJ | 학술논문

背景:心血管支架作为一种异体物质,置入后存在明显的炎症反应过程,主要表现在凝血系统的激活以及炎性标志物血清C-反应蛋白的显著升高.目的:总结探讨支架置入后冠状动脉粥样硬化性心脏病患者炎症反应及C-反应蛋白的变化.方法:应用计算机检索中文期刊全文数据库1990/2009相关文献,检索词为"心血管支架,C-反应蛋白,炎症反应",同时检索PubMed数据库1990/2009相关文献,检索词为"cardiovascular stent on plasma,c-reactive protein".结果与结论:药物涂层支架以金属支架为载体携带药物到达血管损伤局部,使药物在较长的时间内充分释放到血管壁内,减少支架置入后再狭窄的发生.抗炎药物涂层支架主要药物为地塞米松、甲泼尼龙等.抗迁移、抗增生药物涂层支架主要药物为雷帕霉素、紫杉醇、放线菌素D等.支持内膜愈合的药物涂层支架主要药物为雌二醇等.经皮冠状动脉支架置入可诱导和加重局部炎症反应,这对血管内皮的增生与再狭窄有重要影响.反映急性炎症反应的敏感指标如血清C-反应蛋白的浓度对于经皮冠状动脉支架置入后心血管事件的发生有预测价值.冠状动脉内支架置入可显著升高血浆C-反应蛋白水平,所以应充分认识炎症反应及血浆C-反应蛋白、细胞因子的变化对防止心血管支架置入后再狭窄起到的重要作用,及早进行预防及干预,从而减少再狭窄率,提高介入治疗效果.
배경:심혈관지가작위일충이체물질,치입후존재명현적염증반응과정,주요표현재응혈계통적격활이급염성표지물혈청C-반응단백적현저승고.목적:총결탐토지가치입후관상동맥죽양경화성심장병환자염증반응급C-반응단백적변화.방법:응용계산궤검색중문기간전문수거고1990/2009상관문헌,검색사위"심혈관지가,C-반응단백,염증반응",동시검색PubMed수거고1990/2009상관문헌,검색사위"cardiovascular stent on plasma,c-reactive protein".결과여결론:약물도층지가이금속지가위재체휴대약물도체혈관손상국부,사약물재교장적시간내충분석방도혈관벽내,감소지가치입후재협착적발생.항염약물도층지가주요약물위지새미송、갑발니룡등.항천이、항증생약물도층지가주요약물위뢰파매소、자삼순、방선균소D등.지지내막유합적약물도층지가주요약물위자이순등.경피관상동맥지가치입가유도화가중국부염증반응,저대혈관내피적증생여재협착유중요영향.반영급성염증반응적민감지표여혈청C-반응단백적농도대우경피관상동맥지가치입후심혈관사건적발생유예측개치.관상동맥내지가치입가현저승고혈장C-반응단백수평,소이응충분인식염증반응급혈장C-반응단백、세포인자적변화대방지심혈관지가치입후재협착기도적중요작용,급조진행예방급간예,종이감소재협착솔,제고개입치료효과.
BACKGROUND: The inflammatory reaction occurs following implantation of cardiovascular stent with manifestations of the activation of blood coagulation system and dramatically increasing of inflammatory markers serum C-reactive protein. OBJECTIVE: To explore the changes of inflammatory reaction and C-reactive protein in coronary artery disease patients following cardiovascular stent implantation.METHODS: A computer-based online search of CNKI (1990/2009) and PubMed databases (1990/2009) was performed for related articles with the key words "cardiovascular stent, C-reactive protein" in Chinese and "cardiovascular stent on plasma, C-reactive protein" in English.RESULTS AND CONCLUSION: Based on the metal stents, drug-eluting stents can transfer the active drugs to the damaged vessels, release them into the vascular wall and inhibit the in-stent restenosis, Main drugs of anti-inflammatory drug-eluting stent include dexamethasone and methylprednisolone. Main drugs of anti-migratory and anti-proliferative drug-eluting stent includerapamycin, paclitaxel and actinomycin D. Main drugs of supporting intima concrescence stent include estradiol. Coronary artery stents implantation can induce and aggravate local inflammation reaction, which have important infection for vascular endodermis hyperplasia and restenosis occurrence. Some impressible index for inflammation reaction, such as levels of C-reactive protein,have predictive value for vascular events following the coronary artery stents implantation. A significant increase in plasma C-reactive protein after coronary stenting has been observed following stent implantation. Therefore, understanding of inflammatory reaction and C-reactive protein, as well as cytokine changes is important for preventing restenosis, early treatment of restenosis, as well as improving treatment effect.