血清ECP水平与药物洗脱支架晚期支架内再狭窄的相关性

目的:探讨嗜酸性粒细胞阳离子蛋白(eosinophil cationic protein, ECP)与药物洗脱支架(drug eluting stent, DES)晚期支架内再狭窄(in-stent restenosis, ISR)的相关性。方法:选取2014年12月至2016年7月在复旦大学附属中山医院植入DES并超过1年后返院复查造影患者202例,根据复查造影结果分为ISR组(100例)和无ISR组(102例),应用夹心酶联免疫吸附(ELISA)法测定血清ECP水平并比较其在2组间差异。在ISR组和无ISR组,根据支架载药涂层,进一步分为永久涂层-DES组(DP-DES亚组)及可降解涂层-DES组(BP-DES亚组),分析血清ECP水平与载药涂层的关系。结果:ISR组血清ECP水平明显高于无ISR组(P=0.003)。手术年龄和ECP水平是晚期ISR形成的独立危险因素。ISR组DP-DES亚组血清ECP水平高于无ISR组DP-DES亚组(P=0.002)。结论:血清ECP水平在晚期ISR患者中显著升高,可能与支架药物涂层有关。

The relationship between serum eosinophil cationic protein levels and late in-stent restenosis of drug-eluting stents

Objective: To explore the relationship between eosinophil cationic protein (ECP) and late in-stent restenosis (ISR) of drug-eluting stent (DES).Methods: Totally, 202 patients who underwent angiography follow up beyond 1 year after DES implantation in Zhongshan Hospital, Fudan University from December 2014 to July 2016 were included. Patients were divided into two groups (ISR, n=100 and non-ISR, n=102) according to the results of radiography review one year later. Serum ECP levels were detected by sandwich ELISA and were compared between the two groups. In subgroup analysis, we divided patients into DP-DES and BP-DES groups according to their implanted stent type.Results: Serum ECP levels were significantly higher in the ISR group than in the non-ISR group (P=0.003). Multivariate regression revealed that serum ECP level and age at surgery were independent risk factors for late ISR formation. In sub-group analysis, serum ECP levels was significantly higher in patients with DP-DES in ISR group compared to non-ISR group (P=0.002).Conclusions: Serum ECP levels were higher in patients with late ISR, and its elevation is related to the type of coating drugs on the stent.