血清C反应蛋白及类金属蛋白酶-9对PCI后血管再狭窄的预测价值

目的研究血清C-反应蛋白(CRP)及类金属蛋白酶-9(MMP-9)对冠状动脉介入治疗(PCI)后血管再狭窄的预测价值。方法 44例行PCI术的冠心病患者,半年后复查冠状动脉造影,根据是否发生再狭窄分为二组,分别测定PCI前及PCI术后24h及半年时血清CRP及MMP-9水平。结果 二组患者血清CRP水平在PCI术后24h升高,术后半年时水平降低,与PCI前比较有统计学意义,P<0.05。再狭窄组及无再狭窄组组间各相应时点比较无统计学意义,P>0.05。无再狭窄组血清MMP-9水平在术后24h与PCI前比较无统计学意义,P>0.05。术后半年时明显下降,与PCI前比较有统计学意义,P<0.05。再狭窄组三个时点血清MMP-9水平无明显变化,P>0.05。术后半年时再狭窄组血清MMP-9水平较无再狭窄组升高,二组比较有统计学意义,P<0.05。结论 存在于PCI早期血清的CRP升高,可能是血管内皮细胞修复的自然过程,其在再狭窄过程中所起的作用值得进一步探讨。PCI术后MMP-9血清水平持续升高,对预测再狭窄的发生具有一定意义。

Predict value of plasma CRP and matrix metailoproteinase-9 on restenosis after PCI

Objective To study the predicted value of plasma C reactive protein (CRP ) and matrix metalloproteinase-9 (MMP-9) on restenosis after percutaneous transluminal coronary artery angioplasty and stent implantation (percutaneous coronary intervention PCI). Methods 44 patients with coronary heart disease (CHD) processed PCI,then angiography followed after 6 months; All patients were divided into 2 groups according to whether the patient occurred restenosis . And test the plasma level of CRP and MMP-9 before PCI. 24 hours after PCI and 6 months. Results The plasma level of CRP of both groups increased at 24 hours after PCI,but decreased after 6 months, and both of them compared with the level before PCI,there was significant change (P<0. 05). But there was no significant difference between restenosis group and non-restenosis group at all time points (P>0. 05). There was no significant difference on plasma MMP-9 level before and after 24 hours of PCI (P>0. 05), but the plasma MMP-9 level declined obviously after 6 months, and there was significant difference comparing to the level before PCI in no restenosis group (P<0. 05). There was no significant change compared with the level of the plasma MMP-9 at all 3 time points in restenosis group (P>0. 05). Comparing to the non-restenosis group,the level of the plasma MMP-9 in restenosis group increased obviously after 6 months,and there was significant difference comparing with both groups (P<0. 05). Conclusion The plasma level of CRP increase at the early stage after PCI. It considered to be the nature process of vascular endothelium repairing, and the mechanism on restenosis after PCI is worthy of farther study. The continuously increased plasma MMP-9 level can predict the occurrence of restenosis after PCI,the plasma MMP-9 level has a significant predictive value on restenosis.