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论著:冠心病介入治疗前后血清白细胞介素18、可溶性CD40L和超敏C反应蛋白变化与早期并发症的关系
Investigation of the Effects of PCI on Serum IL-18, sCD40L and hs-CRP Levels in Patients with Coronary Artery Disease and the Relationship between Early Complications
晋群 秦永文 李晓燕 许琳 张洪明
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作者单位:济南军区总医院心内科
中文关键字:冠心病;白细胞介素18;CD40L;超敏C反应蛋白;经皮冠状动脉介入治疗;早期并发症
英文关键字:Coronary heart disease; IL-18; CD40L; hsCRP; Percutaneous coronary intervention; Early complications
中文摘要:目的:通过检测经皮冠状动脉介入治疗(PCI)术前、术后血清白细胞介素18(IL-18)、可溶性CD40L(sCD40L)和超敏C反应蛋白(hsCRP)的水平,探讨其与冠心病PCI术后早期并发症之间的关系。方法:选择经冠状动脉造影确诊的冠心病患者85例,其中不稳定型心绞痛患者44例,急性心肌梗死患者41例;选择40例冠状动脉造影正常者作为对照组。采用双抗体夹心酶联免疫吸附分析(ELISA)法测定PCI术前术后血清IL-18、CD40L和hsCRP水平,同时通过对PCI术中、术后30 d早期并发症的观察,探讨PCI手术前后血清IL-18及hsCRP水平与PCI早期并发症之间的关系。结果:85例患者PCI术后心脏早期并发症总发生率为9.4%(8/85),其中AMI组14.6%(6/41)显著高于不稳定型心绞痛(UA)组4.5%(2/44)(P<0.05),术后IL-18、CD40L和hs-CRP水平差值也显著高于无早期并发症患者(P<0.05),发生早期并发症者术前IL-18、CD40L及hsCRP水平及术后差值均显著高于未发生并发症者(P<0.05)。结论:PCI术可能在短期内触发并加重了冠状动脉炎性反应,IL-18、CD40L和hsCRP有可能作为早期并发症的预测因子。
英文摘要:Objective: To explore the changes of serum levels of IL-18, sCD40L and hsCRP in coronary artery disease after PCI and to investigate the prognostic value of IL-18 and hsCRP for early complications after PCI.Methods: A total of 85 patients with ACS which including 44 patients with UA and 41 patients with AMI were enrolled. All patients were treated by PCI. The pre-and pro-procedural levels of serum IL-18 and hsCRP were tested to investigate the changes of serum levels of IL-18, sCD40L and hsCRP and the prognostic value for early complications after PCI. Results: Incidence of the early complications was 9.4 %(8/85) in the whole population, incidence in AMI 14.6 %(6/41) was higher than that in UA 4.5 %(2/44) (P<0.05). The levels of serum IL-18, sCD40L and hsCRP of patients of early complications before PCI was higher than those without early complications before PCI (P<0.05). The increase of serum IL-18, sCD40L and hsCRP of patients of early complications after PCI was higher than those without early complications after PCI (P<0.05). Conclusions: The earlier inflammation reaction in coronary artery may be triggered and aggravated by PCI. The occurrence of early complications after PCI may concerned with inflammatory responses.IL-18, sCD40L and hsCRP may provide more powerful predictors of early complications after PCI.
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