冠心病患者介入治疗前后PIGF和CRP的变化及临床意义

目的:探讨冠心病介入治疗前后PIGF和CRP的变化,从而为冠心病的合理治疗与预防提供机制参考。方法:冠心病患者100例分为单支病变组40例,双支病变组40例和三支病变组20例,检测三组介入治疗前l天,术后l天、3天和7天的PIGF和CRP的变化,同时随访6个月,主要观察心血管事件(MACE)发生情况。结果:经过观察分析,三组冠心病患者介入术后l天胎盘生长因子水平较手术前明显升高(P<0.05),在手术后3天达到高蜂(P<0.01),而在手术后7天与手术前相比差异无显著意义(P>0.05)。而CRP是在手术后l天明显高于手术且达到高峰(P<0.01),然后逐渐下降,到手术后7天恢常左右(P>0.05)。同时上述指标在单支病变组、双支病变组和三支病变组的含量是逐渐增高,但是变化趋势相同。发生心血管事件的患者术前和术后胎盘生长因子和CRP水平峰值明显高于未发生心血管事件的患者,经Logistic回归分析显示,胎盘生长因子、CRP是冠心病患者PCI术后发生心血管事件的独立相关危险因素。结论:PIGF和CRP是冠心病患者血管炎症和不良预后两个强力预测临床生物标记,有望成为冠心病临床诊断和治疗效果评价的重要指标。

PIGF and CRP Variations of Interventional Therapy in Coronary Disease and Clinical Meaning

Objcctive:To explore PIGF and CRP variations before and after interventional therapy in coronary disease for the reference in treatment of proper treatment and prevention of coronary disease.Methods:Patients with coronary disease were equally divided into one diseased vessel group(40).two diseased vessel group(40) and three diseased vessel group(20).PIGF and CRP variations 1 day before treatment and 1 day,3 days and 7 days after operation were checked;meanwhile,in the follow-up 6 months,cardiovascular event(MACE) occurrence was mainly observed.Results:By observational analysis,placenta growth factor of the 3 groups treated with interventional therapy increased than before significantly(P<0.05),up to the peak 3 days after operation(P<0.01).However,it showed no significant difference 7 days after operation and before operation(P>0.05).CRP 1 day after operation increased significantly than before operation and reached the peak(P<0.01).And it gradually decreased and became normal 7 days after operation(P>0.05). Meanwhile,contents of the above indexes in one diseased vessel group,two diseased vessel groups and three diseased vessel groups gradually increased in the same trend.Patients with cardiovascular event showed more significant placenta growth factor and CRP levels than those without cardiovascular event.Logistic regression analysis shows placenta growth factor,CRP is separate related risky factor of occurrence of cardiovascular cvent.Conclusion:PIGF and CRP are 2 strong predictive clinical biological marks for patients with coronary disease and poor prognosis The marks are likely to become crucial indexes for clinical diagnosis of coronary disease and evaluation of curative effect.