血清谷氨酰转移酶水平与支架内再狭窄患者炎症反应及血管新生的关系

摘要

Objective To study the relationship among level of serum glutaminyl transferase (GGT), inflammatory response and angiogenesis in patients with stent restenosis. Methods The patients with acute coronary syndrome (ACS) undergone PCI (n=131) were chosen from the Second Affiliated Hospital of Guangxi Medical University from Jan. 2015 to Jan. 2017. All patients were followed up for 12 months, and they were divided into restenosis group (n=12) and non-restenosis group (n=119) according to results of follow-up. The level of GGT before and 24 h after PCI, inflammatory indexes including C-reactive protein (CRP), interferon-γ (IFN-γ), interleukin-6 (IL-6), IL-8 and IL-18,and indexes related to angiogenesis including vascular endothelial growth factor (VEGF), angiopoietin-1 (Ang-1) and Ang-2 were compared between 2 groups before and 24 h after PCI. The correlation among serum GGT, inflammatory factors and angiogenesis indexes were analyzed. Results The incidence of multi-vessel lesions was higher in restenosis group than that in non-restenosis group (all P<0.05). The levels of GGT, CRP, IFN-γ, IL-6, IL-8 and IL-18 increased significantly in 2 groups after PCI, and were higher in restenosis group than those in non-restenosis group (all P<0.05). The levels of VEGF, Ang-1 and Ang-2 were decreased significantly after PCI, and were lower significantly in restenosis group than those in non-restenosis group (all P<0.05). The results of Pearson correlation analysis showed that serum GGT was positively correlated to all inflammatory factors, and negatively correlated to angiogenesis indexes (all P<0.05). Conclusion The increase of serum GGT level can indict the occurrence of stent restenosis after PCI, which is correlated to inflammatory response and angiogenesis inhibition and may be an important mechanism involved in stent restenosis.%目的 研究血清谷氨酰转移酶(GGT)水平与支架内再狭窄患者炎症反应及血管新生的关系.方法 选取2015年1月~2017年1月于广西医科大学第二附属医院接受经皮冠状动脉介入治疗(PCI)的急性冠脉综合征患者131例为研究对象.对所有患者均进行为期12个月的随访,根据随访结果将其分为支架内再狭窄组12例与无狭窄组119例.分别比较两组手术前与手术后24 h血清GGT水平,各项炎症指标:C反应蛋白(CRP)、γ-干扰素(IFN-γ)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)以及白细胞介素-18(IL-18);以及血管新生相关指标:血管内皮生长因子(VEGF)、血管生成素1 (Ang-1)以及血管生成素2(Ang-2)水平,并作血清GGT与炎症因子、血管新生指标的相关性分析.结果 再狭窄组多支病变发生率高于无再狭窄组(P均＜0.05).术后两组的血清GGT、CRP、IFN-γ、IL-6、IL-8以及IL-18水平均明显高于术前,且再狭窄组又高于无再狭窄组,差异均有统计学差异(P均＜0.05).术后两组的VEGF、Ang-1以及Ang-2水平均分别明显低于术前,且再狭窄组又明显低于无再狭窄组,差异均有统计学意义(P均＜0.05).经Pearson相关性分析可得,血清GGT与各项炎症因子均呈正相关,与血管新生指标均呈负相关(P均＜0.05).结论 血清GGT水平升高可预测PCI术后支架内再狭窄的发生,与炎症反应及抑制血管新生密切相关,可能是参与支架内再狭窄的重要机制.