CAJ | 학술논문

目的了解白细胞、C反应蛋白、纤维蛋白原等炎症因子对冠心病(CHD)患者经皮冠状动脉介入(PCI)术后支架再狭窄的影响.方法对748例经冠状动脉造影(管腔狭窄≥50％)证实为CHD患者进行PCI治疗,其中222例经冠状动脉造影随访,造影证实原支架内血管直径狭窄≥50％,定为支架内再狭窄.再狭窄组86例,无再狭窄组136例.入院当日详细记录2组患者病史,进行体格和血常规检查；次日晨空腹取静脉血检查血脂、血糖、血浆纤维蛋白原、C反应蛋白和肝、肾功能等.对2组各项数据进行分析总结.结果再狭窄组与无再狭窄组比较,年龄、外周血中性粒细胞、血小板计数和血脂水平差异无统计学意义(P＞0.05)；再狭窄组吸烟、高血压、糖尿病患者比例以及外周血白细胞计数、血浆C反应蛋白和纤维蛋白原水平均高于无再狭窄组[吸炯:63.9％ (55/86)比48.5％ (66/136),高血压:77.9％(67/86)比64.7％ (88/136),糖尿病:50.0％ (43/86)比22.8％ (31/136),白细胞计数:(8.8±1.2)×109/L比(7.1 ±2.5)× 109/L,C反应蛋白:(15±26)mg/L比(7±16) mg/L,纤维蛋白原:(3.6 ±0.8)g/L比(3.3 ±0.9) g/L,均P＜0.05].Logistic回归分析显示吸烟、糖尿病和外周血白细胞计数增高对支架内再狭窄有明显影响(P＜0.05).结论炎症因子白细胞、血浆C反应蛋白和纤维蛋白原水平对PCI术后支架再狭窄有明显影响,传统危险因素吸炯、糖尿病、高血压明显影响PCI术后炎症的恢复,增加支架内再狭窄发生率.
목적 료해백세포、C반응단백、섬유단백원등염증인자대관심병(CHD)환자경피관상동맥개입(PCI)술후지가재협착적영향.방법 대748례경관상동맥조영(관강협착≥50％)증실위CHD환자진행PCI치료,기중222례경관상동맥조영수방,조영증실원지가내혈관직경협착≥50％,정위지가내재협착.재협착조86례,무재협착조136례.입원당일상세기록2조환자병사,진행체격화혈상규검사；차일신공복취정맥혈검사혈지、혈당、혈장섬유단백원、C반응단백화간、신공능등.대2조각항수거진행분석총결.결과 재협착조여무재협착조비교,년령、외주혈중성립세포、혈소판계수화혈지수평차이무통계학의의(P＞0.05)；재협착조흡연、고혈압、당뇨병환자비례이급외주혈백세포계수、혈장C반응단백화섬유단백원수평균고우무재협착조[흡형:63.9％ (55/86)비48.5％ (66/136),고혈압:77.9％(67/86)비64.7％ (88/136),당뇨병:50.0％ (43/86)비22.8％ (31/136),백세포계수:(8.8±1.2)×109/L비(7.1 ±2.5)× 109/L,C반응단백:(15±26)mg/L비(7±16) mg/L,섬유단백원:(3.6 ±0.8)g/L비(3.3 ±0.9) g/L,균P＜0.05].Logistic회귀분석현시흡연、당뇨병화외주혈백세포계수증고대지가내재협착유명현영향(P＜0.05).결론 염증인자백세포、혈장C반응단백화섬유단백원수평대PCI술후지가재협착유명현영향,전통위험인소흡형、당뇨병、고혈압명현영향PCI술후염증적회복,증가지가내재협착발생솔.
Objective To understand certain inflammatory factors of in-stent restenosis among coronary heart disease (CHD) patients undergoing percutaneous coronary intervention (PCI).Methods Totally 748 patients diagnosed by coronary angiography (luminal stenosis ≥ 50％) were treated by PCI.222 cases with the original stent vascular diameter stenosis ≥ 50％ were confirmed by coronary angiography.The history,physical examination,the blood test,blood glucose,lipid screening,plasma fibrinogen,C reactive protein,liver and renal function were recorded on the day of admission in two groups(restenosis group 86 cases,none-restenosis group 136 cases).These data was analyzed and summarized.Results Compared with restenosis group,age,peripheral blood neutrophils,platelets and blood lipid levels were not statistically different in none-restenosis group (P ＞ 0.05);Smoking,hypertension,diabetes mellitus,peripheral white blood cell count,plasma C reactive protein and fibrinogen in restenosis group were higher than those in none-stenosis group [smoking:63.9％ (55/86)vs 48.5％ (66/136),hypertension:77.9％ (67/86) vs 64.7 ％ (88/136),diabetes mellitus:50.0％ (43/86) vs 22.8％ (31/ 136),white blood cell count:(8.8 ± 1.2) × 109/L vs(7.1 ±2.5) × 109/L,C reactive protein:(15 ±26) mg/L vs (7 ± 16) mg/L,fibrinogen:(3.6 ± 0.8) g/L vs (3.3 ± 0.9) g/L,P ＜ 0.05].Logistic regression analysis showed that smoking,diabetes and peripheral white blood cell count could increase in-stent restenosis (P ＜ 0.05).Conclusion Inflammatory leukocytes,plasma C reactive protein and fibrinogen levels can aggrandize stent restenosis in patients after PCI; traditional risk factors such as smoking,diabetes mellitus,hypertension can significantly delay the recovery of inflammation and increase the incidence of in-stent restenosis in patients after PCI.