炎症因子对冠心病患者经皮冠状动脉介入术后支架再狭窄的影响

目的了解白细胞、C反应蛋白、纤维蛋白原等炎症因子对冠心病（CHD）患者经皮冠状动脉介入（PCI）术后支架再狭窄的影响。方法对748例经冠状动脉造影（管腔狭窄≥50％）证实为CHD患者进行PCI治疗，其中222例经冠状动脉造影随访，造影证实原支架内血管直径狭窄≥50％，定为支架内再狭窄。再狭窄组86例，无再狭窄组136例。入院当日详细记录2组患者病史，进行体格和血常规检查；次日晨空腹取静脉血检查血脂、血糖、血浆纤维蛋白原、c反应蛋白和肝、肾功能等。对2组各项数据进行分析总结。结果再狭窄组与无再狭窄组比较，年龄、外周血中性粒细胞、血小板计数和血脂水平差异无统计学意义（P〉0．05）；再狭窄组吸烟、高血压、糖尿病患者比例以及外周血白细胞计数、血浆C反应蛋白和纤维蛋白原水平均高于无再狭窄组吸烟：63．9％（55／86）比48．5％（66／136），高血压：77．9％（67／86）比64．7％（88／136），糖尿病：50．0％（43／86）比22．8％（31／136），白细胞计数：（8．8±1．2）×10^9／L比（7．1±2．5）×10^9／L，C反应蛋白：（15±26）mg／L比（7±16）mg／L，纤维蛋白原：（3．6±0．8）g/L比（3．3±0．9）g/L，均P〈0．05。Logistic回归分析显示吸烟、糖尿病和外周血白细胞计数增高对支架内再狭窄有明显影响（P〈0．05）。结论炎症因子白细胞、血浆C反应蛋白和纤维蛋白原水平对PCI术后支架再狭窄有明显影响，传统危险因素吸炯、糖尿病、高血压明显影响PCI术后炎症的恢复，增加支架内再狭窄发生率。

Effect of inflammation factors on stent restenosis after percutaneous coronary intervention in patients with coronary heart disease

Objective To understand certain inflammatory factors of in-stent restenosis among coronary heart disease （CHD） patients undergoing pereutaneous coronary intervention （PCI）. Methods Totally 748 patients diagnosed by coronary angiography （ lmninal stenosis ≥ 50% ） were treated by PCI. 222 cases with the original stent vascular diameter stenosis≥ 50% were confirmed by coronary angiography. The history, physical examination,the blood test, blood glucose, lipid screening, plasma fibrinogen, C reactive protein, liver and renal function were recorded on the day of admission in two groups（ restenosis group 86 cases, none-restenosis group 136 cases）. These data was analyzed and summarized. Results Compared with restenosis group,age, peripheral blood neutrophils, platelets and blood lipid levels were not statistically different in none-restenosis group （ P 〉 0. 05 ） ; Smoking, hypertension, diabetes mellitus, peripheral white blood cell count, plasma C reactive protein and fibrinogen in restenosis group were higher than those in none-stenosis group smoking： 63.9% （55/86） vs 48.5% （ 66/136 ）, hypertension ： 77.9 % （ 67/86 ） vs 64.7 % （ 88/136 ）, diabetes mellitus ： 50. 0% （ 43/86 ） vs 22. 8 % （ 31 / 136） , white blood cell count： （8.8 ± 1.2）] 109/L vs（7. 1 ±2. 5） ×10^9/L, C reactive protein： （ 15 ±26） mg/L vs （ 7 ± 16 ） rag/L, fibrinogen ： （ 3.6 ± 0. 8 ） g/L vs （ 3.3 ± 0. 9 ） g/L, P 〈 0. 05]. Logistic regression analysis showed that smoking, diabetes and peripheral white blood cell count could increase in-stent restenosis （ P 〈 0. 05 ）. Conclusion Inflammatory leukocytes, plasma C reactive protein and fibrinogen levels can aggrandize stent restenosis in patients after PCI; traditional risk factors such as smoking, diabetes mellitus, hypertension can significantly delay the recovery of inflammation and increase the incidence of in-stent restenosis in patients after PCI.