血管紧张素-(1-7)与冠心病患者经皮冠状动脉介入治疗后支架内再狭窄的关系

目的探究血管紧张素(angiotensin,Ang)-(1-7)与冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后支架内再狭窄的关系。方法选取四川现代医院心血管内科2014年7月至2017年12月之间行PCI治疗的冠心病患者220例,根据患者2年后随访复查冠状动脉造影的结果分为再狭窄组(n=26)和非再狭窄组(n=158)。选择同期我院体检无冠心病者56例作为正常对照组。对3组研究对象血清Ang-(1-7)、内皮素(endothelin,ET)-1、白细胞介素(interleukin,IL)-6及IL-8的浓度进行比较分析。结果再狭窄组患者血清Ang-(1-7)浓度较健康对照组及非狭窄组低,而ET-1、IL-6及IL-8浓度高于非狭窄组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示患者血清Ang-(1-7)浓度与血清IL-6(r=-0.956,P=0.002)、IL-8(r=-0.922,P=0.035)及ET-1(r=-0.920,P=0.031)浓度呈负相关。单因素Logistic分析结果显示Ang-(1-7)是冠心病患者PCI治疗后支架内再狭窄的危险因素(回归系数为0.337,OR=1.257,95%CI:1.034~1.435,P<0.001)。结论Ang-(1-7)可通过影响血管内皮细胞的功能及介导炎症反应参与PCI治疗后支架内再狭窄的发生、发展过程。

Correlation between angiotensin-(1-7)and in-stent restenosis after percutaneous coronary intervention in patients with coronary heart disease

Objectives To investigate the correlation of angiotensin(Ang)-(1-7)and in-stent restenosis after percu⁃taneous coronary intervention(PCI)in patients with coronary heart disease.Methods A total of 220 patients with coronary heart disease who underwent PCI between July 2014 and December 2047 in Sichuan Modern Hospital were enrolled.According to the results of coronary angiography of 2-year-follow-up,the patients were divided into resteno⁃sis group and non-restenosis group.At the same period,56 people who accepted physical examination in our hospital without coronary heart disease were in normal control group.Serum concentrations of Ang-(1-7),endothelin(ET)-1,interleukin(IL)-6 and IL-8 were compared and analyzed among the three groups.Results Serum concentration of Ang-(1-7)in patients with restenosis was significantly lower than that of normal control group and non-stenosis group,while concentrations of ET-1,IL-6 and IL-8 were significantly higher than those of non-stenosis group(P<0.05).Serum concentration of Ang-(1-7)negatively correlated with serum concentrations of IL-6(r=-0.956,P=0.002),IL-8(r=-0.922,P=0.035)and ET-1(r=-0.920,P=0.031).Single factor Logistic analysis showed that Ang-(1-7)was a risk factor for restenosis in the posterior stent in patients with coronary heart disease after PCI(regression coefficient=0.337,OR=1.257,95%CI:1.034~1.435,P<0.001).Conclusions Ang-(1-7)can participate in the development of in-stent restenosis after PCI by affecting the function of vascular endothelial cells and mediating inflammatory response.