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目的探讨不稳定型心绞痛患者经皮冠状动脉介入治疗(PCI)术中分别静脉应用普通肝素或低分子肝素对血浆肝细胞生长因子(HGF)的影响。方法74例不稳定型心绞痛患者根据PCI术时使用肝素类型分为普通肝素组(49例)和低分子肝素组(25例),分别在术前、术中、术后即刻以ELISA法测定外周血HGF的水平。结果两组术前HGF水平差异无统计学意义。普通肝素组和低分子肝素组术中及术后即刻HGF水平与术前相比均显著升高(术后中与术前比较:普通肝素组为12322.19±3723.31ng/L比1736.09±603.95ng/L,P<0.00001;低分子肝素组为9141.31±2521.91ng/L比1675.28±630.53ng/L,P<0.00001。术后即刻与术前HGF水平比较:普通肝素组为13565.60±3768.99ng/L比1736.09±603.95ng/L,P<0.00001;低分子肝素组为10092.35±2723.00ng/L比1675.28±630.53ng/L,P<0.00001)。低分子肝素组在PCI术中和术后即刻两个不同时段其外周血HGF水平均低于普通肝素组(P均<0.01)。结论不稳定型心绞痛患者在PCI术中无论是应用普通肝素还是低分子肝素,均可促进外周血HGF的释放,但在PCI术手术过程中,静脉注射普通肝素升高外周血HGF的作用比低分子肝素更强。
Objective To investigate the effects of unfractionated heparin (LMWH) or low molecular weight heparin (LMWH) on plasma hepatocyte growth factor (HGF) in patients with unstable angina pectoris undergoing percutaneous coronary intervention (PCI). Methods 74 patients with unstable angina pectoris were divided into two groups: unfractionated heparin group (n = 49) and low molecular weight heparin group (n = 25) according to the types of heparin used during PCI. The peripheral Blood HGF levels. Results There was no significant difference in preoperative HGF levels between the two groups. The levels of HGF in both unfractionated heparin group and low molecular weight heparin group during surgery and immediately after operation were significantly higher than those before operation (compared with preoperation: 12322.19 ± 3723.31ng / L in unfractionated heparin group and 1736.09 ± 603.95ng / L, P <0.00001; low molecular weight heparin group was 9141.31 ± 2521.91ng / L than 1675.28 ± 630.53ng / L, P <0.00001 .After operation and preoperative HGF levels: unfractionated heparin group was 13565.60 ± 3768.99ng / L 1736.09 ± 603.95ng / L, P <0.00001; low molecular weight heparin group was 10092.35 ± 2723.00ng / L than 1675.28 ± 630.53ng / L, P <0.00001). In low molecular weight heparin group, the levels of HGF in peripheral blood were lower than those in unfractionated heparin group during PCI and immediately after operation (all P <0.01). Conclusions Unstable angina pectoris can promote the release of HGF in peripheral blood regardless of whether unfractionated heparin or low molecular weight heparin is used in PCI. However, in the course of PCI, unfractionated heparin is more effective in raising HGF in peripheral blood Molecular heparin stronger.