摘要:
Objective]To study the changes of endothelin (ET)and the von Willebrand factor (vWF)before and af-ter interventional therapy in patients with coronary heart disease and the use of the two variables in predicting the presence of postoperative complications.[Methods]Two hundred and seventy-three patients with coronary heart disease in our hos-pital from January 2014 to January 2010 were selected,and the levels of serum ET and vWF were carefully monitored at certain time intervals.Additionally,the presence of postoperative complications after one year were compared with the changes of serum ET and vWF to find any correlation.[Results]Serum ET and vWF levels in the Acute Myocardia Infarc-tion (AMI)group,Unstable Angina Pectoris (UAP)group,and Stable Angina Pectoris (SAP)group before surgery,30 minutes after,and 24 hours after surgery were all significantly higher than those of the control group.The difference was statistically significant (all P <0.05).The serum Et and vWF levels in the AMI,UAP,SAP groups before surgery,30 minutes after,24 hours after,and three days after surgery were presented first as increasing and then decreasing.,The serum ET level reached its peak 30 min after the surgery while the serum vWF level peaks at 24 hours after the surgery. Peak levels of serum ET and vWF in patients with complications were significantly higher than the peak levels in the pa-tients without complications (P <0.05).Logistic regression analysis of hypertension (RR = 1.752,P =0.033),diabe-tes (RR = 1.325,P =0.038),preoperative ET level (RR = 2.896,P =0.041),and preoperative vWF levels (RR =2.336,P =0.035)were statistically significant (P <0.05)in predicting PCI complications.[Conclusion]Endothelin and the von Willebrand factor can reflect the damage of endothelium to provide value for predicting the presence of postopera-tive complications in patients with coronary heart disease..%【目的】研究冠心病患者行经皮冠状动脉介入术(PCI)前后内皮素(ET)、血管性假血友病因子(vWF)的变化以及对术后并发症的预测价值。【方法】选择2010年1月至2014年1月本院心内科住院收治的273例行PCI 治疗的冠心病患者,比较其不同时间点血清 ET、vWF 水平变化,并观察研究对象术后1年内并发症发生情况与血清 ET、vWF 水平的相关性。【结果】急性心肌梗死(AMI)组,不稳定型心绞痛(UAP)组,稳定型心绞痛(SAP)组术前、术后30 min 以及术后24 h 血清 ET、vWF 水平均显著高于对照组,差异均有统计学差异(均 P <0.05);AMI 组、UAP 组、SAP 组术前、术后30 min、术后24 h、术后3 d 血清 ET、vWF 水平均呈现先升高后降低态势,其中血清 ET 水平术后30 min 为峰值,血清 vWF 水平术后24 h 为峰值;PCI 术后发生并发症患者血清 ET、vWF 峰值水平显著高于无并发症患者,差异有统计学意义(P <0.05)。logstic 回归分析显示高血压(RR=1.752,P =0.033)、糖尿病(RR=1.325,P =0.038)、术前 ET 水平(RR=2.896,P =0.041)、术前 vWF 水平(RR=2.336,P =0.035)是 PCI 术后并发症的高危因素。【结论】血清 ET、vWF 水平可反映 PCI 术后患者内皮损伤情况,对患者预后评估有重要的临床应用价值。