长球囊血管成形术并长支架置入对下肢缺血者血清IL6和CRP的影响

目的：比较长球囊血管成形术联合长支架置入术（LBPTALS）与普通球囊血管成形术联合普通支架置入术（OBPTAOS）对血清IL-6和C反应蛋白（CRP）浓度的影响。方法：选择经下肢血管造影证实为股浅动脉狭窄单支病变的糖尿病下肢缺血患者43例，随机分为两组，分别接受长球囊血管成形术（LBPTA）及长支架（LS）或普通球囊血管成形术（OBPTA）及普通支架（OS）。分别于术前，术后即刻、2h和6h抽取患肢静脉血测定血清IL-6含量，另于术前，术后6、24和48h抽取患肢静脉血测定血清CRP的浓度。血清IL-6和CRP的浓度均以ELESCA双抗体夹心法进行测定。结果：两组患者靶病变情况差异无统计学意义。LBPTALS组的手术时间、夹层数、置入支架数和球囊扩张次数明显低于OBPTAOS组（P（0．05～〈0．01）。OBPTAOS组IL-6浓度在术后即刻开始高于LBPTALS组，术后2h和6h差异进一步增大（P〈0．01）。OBPTAOS组的CRP浓度在术后6，24和48h都明显高于LBPTALS组（P〈0．01）。结论：LBPTALS对糖尿病下肢缺血患者血清IL-6和C反应蛋白浓度的影响均小于OBPTAOS，前者这种减轻炎症反应的影响，可能是其减少再狭窄的机制之一。

Effects of long balloon percutaneous transluminal angioplasty plus long stent implantation on serum IL26 and CRP in patients with lower extremity ischemia

Objective:To compare the effects of LBPTALS and OBPTAOS on serum IL-6 and CRP levels in patients with diabetes and lower extremity ischemia.Methods:A total of 43 patients with single superficial femoris artery stenosis were randomly divided into long balloon percutaneous transluminal angioplasty plus long stent implantation(LBPTALS) group and ordinary balloon percutaneous transluminal angioplasty plus ordinary stent implantation(OBPTAOS) group.Lower extremity vein blood was collected before angioplasty,immediately after stent implantation as well as 2h and 6h after stent implantation to measure the content of IL-6,or before angioplasty,6h as well as 24 h and 48 h after angioplasty to measure the serum content of CRP.The serum levels of IL-6 and CRP were all measured by ELESCA.Results:There was no significant difference of the characteristics of the target lesions between two groups.The operating time,number of dissecting or implanted stent and the number of balloon expandding of LBPTALS group was significantly less than those of OBPTAOS group(P<0.05~<0.01).The serum level of IL-6 was significantly higher in group OBPTAOS than that of LBPTALS group immediate after angioplasty,also keep raising at 2 h and 6 h(P<0.01).The serum level of CRP was significantly higher in OBPTAOS group than that of LBPTALS group at 6h as well as 24 h and 48 h after angioplasty(P<0.01).Conclusion:The results suggest that LBPTALS can significantly reduce the production of IL-6 and CRP than those of OBPTAOS.This may indicate that LBPTALS produce less vessel wall injury and,consequently,less inflammation stimulate,which may account for the lower rate of restenosis.