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目的探讨内脏脂肪素与冠心病的相关性及 PCI 术后变化的意义。方法:90 例冠心病患者分为急性心肌梗死组 30 例、不稳定心绞痛组 30 例、稳定心绞痛组 30 例,均行冠脉造影确诊,其中 52 例患者行 PCI术。另选正常对照组 30 例 . 用酶联免疫法检测各组及PCI 术后血浆内脏脂肪素(visfatin)水平,于生化室检测肝功、肾功、血糖、血脂、高敏 C 反应蛋白(hs-CRP), 对行 PCI 术患者记录病变支数,植入支架个数及长度,最大球囊扩张压力,术后 TIMI 血流分级。结果:冠心病组 visfatin 和 hs-CRP 高于对照组,且 AMI 组和UAP 组较 SAP 组升高更明显,各组间有显著性差异(p<0.05), 冠心病组 visfatin 与 hs-CRP 水平的独立相关 (p<0.001), PCI 术后 visfatin 水平高于术前(p<0.01),且与最长支架长度和植入支架个数相关(p<0.05)。结论:血浆 visfatin 的水平反应斑块的不稳定程度,其参与冠脉硬化发生发展的过程,另外 PCI 术后 visfatin 较术前升高,可能参与术后再狭窄。
Objective To investigate the correlation between visfatin and coronary heart disease and its significance after PCI. Methods: Ninety patients with coronary heart disease were divided into acute myocardial infarction group (30 cases), unstable angina group (30 cases) and stable angina pectoris group (30 cases). Coronary angiography was performed in 52 patients. The other 30 cases were selected as normal control group, visfatin level was measured by enzyme-linked immunosorbent assay (ELISA), liver function, renal function, blood glucose, blood lipid, high sensitivity C-reactive protein (hs- CRP). The number of lesions, the number and length of stent implantation, the maximum balloon dilatation pressure and TIMI grade were recorded after PCI. Results: The levels of visfatin and hs-CRP in coronary heart disease group were higher than those in control group. The levels of visfatin and hs-CRP in coronary heart disease group were significantly higher than those in SAP group (p <0.05) (P <0.001). The level of visfatin after PCI was higher than that before operation (p <0.01) and was related to the longest stent length and the number of stents implanted (p <0.05). Conclusion: The level of visfatin in plasma reflects the degree of instability of plaque, which is involved in the development of coronary sclerosis. In addition, visfatin may be involved in restenosis after PCI.