冠状动脉介入干预对患者血流动力学及血清炎性因子水平的影响

摘要

目的：分析冠状动脉介入干预对患者血流动力学及血清炎性因子水平的影响。方法选取76例冠心病患者，依据患者接受的介入操作不同分为观察组（PCI 术）41例，对照组（常规冠状动脉造影检查）35例。比较两组患者介入手术相关资料，包括：造影剂使用量、校正的 TIMI 帧数（CTFC）、平均动脉压等；比较两组患者术后24 h 血清炎性因子指标；分析观察组患者术后 CTFC 与白介素-6（IL-6）及金属蛋白酶-9（MMP-9）的相关性。结果观察组患者造影剂使用量显著高于对照组（t ＝6．371，P ＜0．01）；观察组术后校正的 TIMI 帧数（CTFC）显著高于对照组（t ＝4．937，P ＜0．01）；观察组术后平均动脉压水平显著高于对照组（t ＝4．499，P ＜0．01）。观察组患者术后24 h 血清 IL-6显著高于对照组（t ＝3．031，P ＜0．01）；观察组术后25 h 血清 MMP-9显著高于对照组（t ＝3．920，P ＜0．01）。相关性分析显示，观察组患者术后血清 IL-6水平与术后 CTFC 呈现显著正相关（r ＝0．700，P ＜0．01）；观察组患者术后血清 MMP-9水平与术后 CTFC 水平呈现正相关，差异有统计学意义（r ＝0．738，P ＜0．01）。结论PCI 术可导致患者血清炎性因子水平升高，且与冠脉血流呈现负相关。%Objective To analyze the effect of percutaneous coronary intervention (PCI)on blood flow dynam-ics and serum cytokines of patients.Methods Seventy-six patients with coronary heart disease were divided into obser-vation (PCI,n =41)and control (coronary angiography,n =35 )groups .Results The contrast agent usage of obser-vation group was significantly higher than control group (t =6.371,P <0.01).The mean arterial pressure and CTFC were significantly higher than those in control group(P <0.01).The levels of serum IL-6 at 24 hours postoperatively and MMP-9 at 25 hours postoperatively were significantly higher than those in control group (P <0.01).The correlation analysis showed that serum IL-6 and MMP-9 were positly associated with CTFC of postoperation (P <0.01).Conclusion PCI can cause serum cytokines increased,which was negative associated with coronary blood flow in CHD patients.