急性心肌梗死患者不同时间炎性因子水平与经皮冠状动脉介入治疗术后支架内再狭窄的相关性研究

摘要

目的 探讨急性心肌梗死(AMI)患者不同时间炎性因子水平与经皮冠状动脉介入治疗(PCI)术后支架内再狭窄(ISR)的相关性.方法 依据术后12个月复查冠状动脉造影结果,将139例行PCI的AMI患者分为非ISR组121例和ISR组18例,分别于PCI术前、术后3 d及术后7 d检测其血清超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-18及诱导蛋白(IP)-10的水平并进行比较.采用多元logistic回归分析PCI术后ISR的影响因素.结果 两组患者PCI术后3 d和7 d的hs-CRP、IL-18及IP-10水平均明显高于同组PCI术前(P<0.05).PCI术后7 d ISR组IP-10水平及非ISR组hs-CRP和IL-18均比同组PCI术后3 d水平低(P<0.05);而ISR组PCI术后3 d和7 d hs-CRP、IL-18水平及非ISR组PCI术后3 d和7 d IP-10水平比较,差异均无统计学意义(P>0.05).ISR组患者PCI术后3 d及7 d hs-CRP、IL-18水平及PCI术后3 d IP-10水平均明显高于非ISR组(P<0.05),而两组间PCI术后7 d IP-10水平比较,差异无统计学意义(P>0.05).多元logistic回归分析结果显示,AMI患者PCI术后3 d和7 d的hs-CRP、IL-18及PCI术后3 d的IP-10水平均为ISR的独立危险因素(P<0.05).结论 AMI患者PCI术后炎性因子水平尤其是术后3 d时炎性因子水平与ISR密切相关.%Objective To explore the correlation between levels of inflammatory factors in different time and in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods According to the results of coronary angiography 12 months after the operation,139 patients with AMI who received PCI were divided into non-ISR group(121 cases)and ISR group(18 cases).Levels of serum hypersensitivity C reactive protein(hs-CRP),interleukin(IL)-18 and induced protein(IP)-10 in two groups were tested and compared before PCI,3 d and 7 d after PCI. Multivariate logistic regression analysis was used to analyze the influential factors of ISR after PCI.Results Levels of hs-CRP,IL-18 and IP-10 in two groups were significantly higher than those before PCI(P <0.05). Level of IP-10 in ISR group and levels of hs-CRP and IL-18 in non-ISR group 7 d after PCI were lower than those in the same group 3 d after PCI(P <0.05).But there were no significant differences in levels of hs-CRP and IL-18 in ISR group and level of IP-10 in non-ISR group between 3 d and 7 d after PCI (P >0.05).Levels of hs-CRP and IL-183 d and 7 d after PCI and level of IP-103 d after PCI in ISR group were significantly higher than those in non-ISR group (P <0.05 ),but there was no significant difference in level of IP-10 between two groups 7 d after PCI(P >0.05).Results of multivariate logistic regression analysis showed that levels of hs-CRP and IL-183 d and 7 d after PCI and IP-103 d after PCI were independent risk factors of ISR.Conclusion Levels of inflammatory factors in patients with AMI after PCI especially 3 d after PCI are closely related with ISR.