文档介绍：肝素涂层支架对粥样硬化冠状动脉的短期保护效应
作者:李妍,李志立,贾国良,郭文怡,李伟杰,李成祥,李媛,李伟,王小燕
【关键词】冠状动脉疾病
关键词: 冠状动脉疾病;支架,肝素;内皮缩血管肽类;降钙素基因相关肽
摘要:目的研究肝素涂层支架(Wiktor-I)植入后,对冠状循环及体循环中血管活性物质内皮素(ET)和降钙素基因相关肽(CGRP)水平的短期影响,为肝素涂层支架的冠状动脉保护机制提供理论依据. 方法选择植入普通无涂层支架(n1 =16)和肝素涂层支架(n2 =14)的两组冠心病患者共30例,于手术前后不同时间点,同时采集冠状静脉窦和外周肘静脉血,采用放射免疫分析法检测血浆ET-1和CGRP浓度,并求出ET/CGRP比值以反映两者的动态平衡. 结果普通支架(NCS)组ET-1水平在支架后即刻和支架后12h呈现大小两个高峰,CGRP的变化与其呈一致性,ET/CGRP比值于PT-CA后5min达高峰,并维持较高水平至术后12h;肝素支架(HCS)组ET-1水平在支架后即刻略低于NCS组,在支架后5min,10min和12h显著降低(P<,P<<),CGRP水平与NCS组无显著差异,ET/CGRP比值于支架后5min,10min和12h显著低于普通组(P<,P<<). 结论肝素支架的近期保护作用的机制之一是通过降低术后ET-1水平,恢复ET/CGRP比值的动态平衡来实现,对防止支架植入术后急性血管痉挛和(亚)急性血栓形成的发生有重要作用.
Keywords:coronary disease;stents,heparin;endothelins;calcitonin gene-related peptide
Abstract:AIM To study the short-term effects of heparin-coated stent(Wiktor-I)on plasma endothelin-1(ET-1)and calcitonin gene-related peptide(CGRP)concentrations in coronary sinus and peripheral vein after stent implantation and provide the theoretical foundation for its protective mech┐ The patients with coronary artery dis-eases(n=30)were divided into non-coated stent(NCS)group(n1 =16)and heparin-coated stent(HCS)group(n 2 =14).Circulating ET-1and CGRP levels were measured by ra-dio immunology assay in both groups of patients at the paired sampling sites:the coronary sinus(Cs)and peripheral vein(Pv).The ratio of ET/CGRP was calculated to reflect the balance of ET and In NCS group plasma ET-1concentration exhibited two peaks at0min and12h af-ter stent implantation,CGRP level was patible with that of ET-1;the ratio of ET/CGRP reached the peak at post-PTCA5min and remained at high levels until post-stent12h,while in HC
S group ET-1level decreased dramat-pared with that of NCS group at post-stent5min,10min and12h(P<,P< P<,respec-tively).There was no evident difference of CGRP level be-tween two groups,the ratio of ET/CGRP being much lower than that o