冠状动脉支架术中内皮素及血管紧张素II的变化(PDF)
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2001年第4期
- 页码:
- 257-259
- 栏目:
- 论著
- 出版日期:
- 2001-07-01
文章信息/Info
- Title:
- Endothelin-1 and angiotensin-II variation in the coronary circulation during angioplasty with stents implantation
- Author(s):
- CAO Feng ; JIA Guo-liang ; GUO Wen-yi; LI Cheng-xiang ; LI Wei-jie; LU An-lin; WANG Xiao-yan
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an Shaanxi 710032, China
- Keywords:
- coronary disease; angioplasty; transluminal; percutaneous coronary; stent; endothelins; angiotensin II
- 分类号:
- R541. 4
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 探讨经皮腔内冠脉成形术(PTCA) 及支架术中血浆内皮素(ET-1) 及血管紧张素II (ATII ) 的变化。方法 44 例冠心病患者随机分成冠脉造影组(10 例) 和PTCA 加支架组(34 例) , 共植入支架48 个, 分别于术前、术中 及术后24 h 内不同时间点采集冠状静脉窦血及股动脉血, 采用放免法测定ET-1 及ATII 的浓度。结果 冠脉造影 前后ET-1 及ATII 无显著变化(P>0. 05) ; PTCA 及支架组在球囊预扩张即刻ET-1 轻度增高(P<0. 05) ,ATII 显 著增高(P<0. 01) ; 支架后即刻ET-1 及ATII 明显降低(P<0. 05) ; 支架后10 min ET-1 及ATII 又有回升。术后 12 h 出现外周血ET-1 及ATII 的升高。结论 冠脉造影对冠脉循环血管活性物质无显著影响; PTCA 加支架术中 存在血管活性物质的波动, 支架植入后即刻, 冠脉循环血中ET-1 及Ang-II 的降低与支架植入后局部血流改善有 关, ET-1 及Ang-II 的延迟释放可能是支架植入术后并发症发生的原因之一。
- Abstract:
- AIM Endothelin-1 ( ET-1 ) and angiotensin II (AT II ) are endothelium-derived mediators with asoconstrictive and mitogenic activity which stimulates vascular smooth muscle cell proliferation. The aim of this study was to evaluate ET-1 and AT II production during percutaneous transluminal coronary angioplasty ( PTCA ) and elective stent implantation.METHODS Ten patients underwent angiography and 34 patients with coronary heart disease underwent PTCA and stenting ( 48 stents were inplanted in 28 stenosis with left anterior descending coronary artery and 9 with circumflex artery lesion and 11 with right coronary artery). Blood samples were obtained from the coronary sinus immediately before and after angiography or in-stent implantation, 1 min after the last pre-stent balloon dilation and 10 min after, blood samples were obtained from stenting. Meanwhile femoral artery immediately befo reand 10min, 6, 12, 24 h after stenting. RESULTS At baseline, ET-1 and ATII levels were higher in the coronary sinus than in femoral artery (ET 21: 57. 2±5. 3 pg/ml vs 51. 2±5. 4 pg/ml, ATII: 52. 97 ±4. 97 pg/ml vs 49. 98 ±5. 84 pg/ml, P<0. 05). Following last pre-inflation, ET-1 coronary sinus levels slightly increased with respect to the basal levels while ATII significantly increased (72. 87±4. 99 pg/ml vs 52. 97±4. 47 pg/ml, P<0. 01). Significant decrease of ET-1 and ATII levels were detected after and ATII levels were detected after stent deployment. There was a second increase of ET-1 and ATII in femoral artery 12 h after procedures. CONCLUSION The lesion by PTCA and stent implantation seems to produce most of ET-1 and ATII circulating in the coronary tree. Despite our expectations, we did not detect any significant ET-1 and ATII increase in coronary circulation immediately after stent deployment, but there was a delayed increase in femoral artery 12 h after this procedures.
参考文献/References
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备注/Memo
- 备注/Memo:
- 收稿日期：2000-06-08.
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