CAJ | 학술논문

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 hs-CRP 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(r s =-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(r s =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。
목적：연합검측급진경피관상동맥개입치료(PCI)전후혈청혈관내피생장인자(VEGF)급고민 C 반응단백(hs-CRP)수평변화,지재탐토급진 PCI 술전후혈청 VEGF 급 hs-CRP 수평변화여급진 PCI 술후재협착적관계。방법검측100례급진 PCI 적 ST 단태고형심기경사(STEMI)환자술전、술후3천、술후7천혈청중 VEGF、hs-CRP수평,근거6개월수방관상동맥조영결과분위재협착조화무재협착조,분석급진 PCI 술후3천화술후7천혈청 VEGF급 hs-CRP 변화수평여술후재협착적관계。결과급진 PCI 술전혈청 VEGF 수평고우술후3천화7천수평(P <0.01)；급진 PCI 술전혈청 hs-CRP 수평저우술후3천수평,이고우술후7천수평(P <0.01)。재협착조급진 PCI 술전혈청 VEGF 수평현저저우무재협착조(P <0.05)；술후3천혈청 VEGF 수평여무재협착조무명현차별(P >0.05)；술후7천혈청 VEGF 수평여무재협착조무명현차별(P >0.05)；술후3천혈청 VEGF 하강폭도명현저우무재협착조(P <0.05)。재협착조급진 PCI 술전혈청 hs-CPR 수평여무재협착조무차별(P >0.05)；술후3천혈청 hs-CRP 수평여무재협착조무명현차별(P >0.05)；술후7천혈청 hs-CPR 수평여무재협착조무명현차별(P >0.05)；술후3천혈청 hs-CPR 승고폭도명현고우무재협착조(P <0.05)。급진 PCI 술후3천혈청 VEGF 하강폭도여급진 PCI술후지가재협착정부상관(r s =-0.411,P <0.05)；술후3천혈청 hs-CPR 승고폭도여급진 PCI 술후지가재협착정정상관(r s =0.414,P <0.05)。결론급진 PCI 술후3천혈청 VEGF 급 hs-CRP 변화수평여급진 PCI 술후재협착고도상관,연합검측급진 PCI 술후3천혈청 VEGF 하강적폭도급술후3천혈청 hs-CRP 승고적폭도,혹가성위예측급진PCI 술후재협착적생화지표。
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 restenosis (r s =0.414,P <0.01).Conclusion The changes of serum VEGF and hs-CRP level at 3 d after emergency PCI are highly associated with stent restenosis.The joint detection of serum VEGF and hs-CRP at 3 d after emergency PCI may be biochemical indexes for predicting stent restenosis after emergency PCI.