冠状动脉内药物洗脱支架植入术后冠状静脉窦血中内皮素-1水平的变化

目的: 观察冠心病患者冠状动脉内支架安置术后冠状静脉窦血浆内皮素-1(ET-1)浓度的动态变化,探讨药物洗脱支架对术后再狭窄防治的作用机制.方法:冠心病患者42例,随机植入药物洗脱支架26例,普通支架16例,分别于冠状动脉球囊扩张术(PTCA)前、支架术后即刻、1 h、3 h和6 h自冠状静脉窦采血检测血浆ET-1的浓度.结果:药物洗脱支架组与普通支架组ET-1水平在术后即刻均降至最低点后即开始回升,到1 h时已超过术前水平,以后普通支架组ET-1水平继续升高,出现释放的第二峰.但药物洗脱支架组程度较为缓和,未出现明显的第二峰,2组ET-1水平在术后6 h差异有统计学意义(P<0.01).结论:药物洗脱支架可有效抑制冠状静脉窦血浆ET-1浓度的升高,可能是其防治再狭窄机制之一.

Changes in the levels of plasma endothelin-1 in coronary sinus after intracoronary drug eluting stent placement

Objective:To investigate the effects of intra coronary drug eluting stent (DES) placement on the level of serum plasma endothelin-1(ET-1) in coronary sinus in patients with coronary heart disease after percutaneous transluminal coronary angioplasty (PTCA). Methods: Forty-two patients with coronary heart disease randomly received DES or bare metal stent (BMS) placement as controls. Placing a right heart catheter into the coronary sinus, we collected blood samples of the patients during the first 6 h after PTCA and stent placement. Levels of plasma ET-1 were determined by non-balanced method. Results: Plasma level of ET-1 didn't change as markedly as the controls (P<0.05). Conclusion:Smooth changes of ET-1 level reflect the improvement of endothelial cell function after drug eluting stent placement, which may play some role in the reduction of long-term restenosis.