经皮冠状动脉介入治疗对不稳定心绞痛患者血浆MMP-9、CRP、IL-18及CTnI的影响和意义
| 作者: |
1胡章乐,
1王晓晨,
1许邦龙,
1盛建龙,
1张艳梅
1 安徽医科大学第二附属医院心血管内科，合肥 230601 |
| 通讯: |
王晓晨
Email: hfdoc@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2015.07.028 |
摘要
目的：研究经皮冠状动脉介入治疗(percutaneous coronar y intervention，PCI)对不稳定心绞痛患者血浆基质金属蛋白酶-9(matrix metalloproteinase-9，MMP-9)、C反应蛋白(C-reactive protein，CRP)、白介素-18(interleukin 18，IL-18)及心肌损伤标记物肌钙蛋白I(cardiac troponin I，CTnI)水平的影响和意义。方法：116例不稳定心绞痛患者，随机分为非PCI(NPCI)组和PCI组。分别测定两组入院时、冠脉造影/PCI术后24、72 h、2周时循环中MMP-9、CRP、IL-18及CTnI浓度进行比较分析。结果：NPCI组和PCI组的基线资料及入院时、术后2周的血浆MMP-9、CRP、IL-18及CTnI浓度均无明显差异(均P>0.05)。NPCI组术后24及72 h的MMP-9、CRP、IL-18及CTnI浓度均与入院时无明显差异(均P>0.05)，其术后2周MMP-9、CRP、IL-18及CTnI低于入院时(均P<0.01)。PCI组术后24 h MMP-9、CRP、IL-18及CTnI浓度显著高于入院时(均P<0.01)，术后72 h的MMP-9、CRP、IL-18及CTnI浓度显著高于PCI组术后24 h(均P<0.01)，术后2周的MMP-9、CRP、IL-18及CTnI浓度显著低于入院时(均P<0.01)。PCI组术后24及72 h的MMP-9、CRP、IL-18及CTnI浓度均显著高于同时点的NPCI组(均P<0.01)。结论：PCI治疗本身可能在短期内加重冠脉斑块不稳定及心肌损伤。
关键词：
易损斑块
不稳定型心绞痛
炎症
经皮冠状动脉介入治疗
Effect of percutaneous coronary intervention on plasma MMP-9, CRP, IL-18 and CTnI in patients with unstable angina pectoris
CorrespondingAuthor: WANG Xiaocheng Email: hfdoc@126.com
DOI: 10.3978/j.issn.2095-6959.2015.07.028
Abstract
Objective: To explore the effect of percutaneous coronary intervention (PCI) on plasma activity of matrix metalloproteinase-9 (MMP-9), C-reactive protein (CRP), interleukin 18 (IL-18) and cardiac troponin I (CTnI) in patients with unstable angina pectoris. Methods: A total of 116 patients with unstable angina pectoris were randomized to non-PCI (NPCI) or PCI treatment. Baseline characteristics of both groups were recorded and the plasma samples were collected on admission and 24, 72 h, 2 weeks after the procedure (coronary angiography for NPCI group, percutaneous coronary intervention for PCI group) respectively in all patients to measure plasma concentration of MMP-9, CRP, IL-18 and CTnI. Results: There was no difference in clinical characteristics and plasma MMP-9, CRP, IL-18 and CTnI levels on admission and 2 weeks after the procedure between both groups (all P>0.05). After the procedure, for NPCI group, there was no difference in MMP-9, CRP, IL-18 and CTnI concentrations amongst the first three timings (all P>0.05). However, their levels dropped at 2 weeks (all P<0.01). After the procedure, for PCI group, MMP-9, CRP, IL-18 and CTnI concentrations markedly increased at 24 h and further elevated at 72 h and then significantly dropped at 2 weeks (all P<0.01). NPCI group illustrated significantly lower plasma MMP-9, CRP, IL-18 and CTnI levels than PCI group at 24 and 72 h after the procedure (all P<0.01). Conclusion: PCI procedure probably induces plaque vulnerability and insult myocardium in a short time.