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目的 血管内皮损伤在经皮冠状动脉腔内成形(PTCA)后的急性与慢性合并症的发生发展中起着重要的作用。本文探讨PTCA术对血管损伤和缩血管物质的影响。方法 4 4例单纯左冠状动脉前降支 (LAD)狭窄的患者 ,被随即分配到单纯球囊扩张 (BA)组 (11例 ) ,血管内放射治疗组 (VBT ,14例 )及支架组 (19例 )。于PTCA术前及术后即刻 ,术后4h和 2 4h从冠状窦取血 ,分别测定内皮素 1(ET 1) ,血管紧张素Ⅱ (ANGⅡ )及vW因子 (vWF)。 7例单纯行冠状动脉造影的患者作为对照组。结果 所有PTCA患者术后即刻ET 1水平显著增高 ,而ANGⅡ及vWF水平在PTCA术后 4h开始明显增高。BA组、VBT组及支架组间上述指标无明显差异。结论 冠状窦血中ET 1及ANGⅡ、vWF水平的改变反应了PTCA术对血管损伤的程度。
Objective Vascular endothelial injury plays an important role in the occurrence and development of acute and chronic complications after percutaneous transluminal coronary angioplasty (PTCA). This article discusses the impact of PTCA on vascular injury and vasoconstrictor substances. Methods Four patients with simple left anterior descending coronary artery (LAD) stenosis were randomly divided into two groups: BA group (n = 11), endovascular radiotherapy group (VBT group, n = 14) 19 cases). Blood samples were obtained from the coronary sinus immediately before and immediately after PTCA, and at 4h and 24h after surgery. Endothelin 1 (ET 1), angiotensin Ⅱ (Ang Ⅱ) and vW factor (vWF) were measured. 7 cases of simple coronary angiography as a control group. Results All patients with PTCA had a significantly higher level of ET 1 immediately after operation, while ANG Ⅱ and vWF levels increased significantly 4 hours after PTCA. BA group, VBT group and stent group between the above indicators no significant difference. Conclusion The changes of ET 1, ANG Ⅱ and vWF levels in coronary sinus blood reflect the degree of vascular injury induced by PTCA.