C反应蛋白与白细胞介素-6对冠脉介入并发症的预测.pdfVIP

生堡急 医堂 蠢2007壁12月第16卷第12期Chin J Emerg Med，DeceⅡ 2007，Vo1．16，No．12 · 临床研究 · C反应蛋白与白细胞介素一6对冠脉介入并发症 的预测 王晖 杨志健 黄峻 马根山 朱铁兵 王连生 曹克将 【摘要】目的 探讨经皮冠状动脉介入治疗 (PCI)术前增强的炎症性反应对急性血管并发症 及早期冠脉事件的预测价值。方法 按照前瞻性临床试验方案，连续选择100例行PCI治疗的稳定 性 (SAP)和不稳定性心绞痛 (UAP)患者，于术前留取外周血标本，分别测定C反应蛋白 (CRP) 和白介素一6(IL-6)水平；通过冠状动脉造影和临床指标判定PCI术中及围术期血管并发症及术后冠 脉事件。结果 100例患者中，13例于术中发生急性管腔闭塞，1例于术后2 d发生亚急性血栓， 均于闭塞处行FIEA和／或支架植入，恢复TIMI HI级血流。余84例术中无并发症发生；术后30 d临 床随访，无缺血性事件及各种原因的死亡发生。血管并发症发生率在CRP下四分位数组与上四分 位数组间差异具有统计学意义 (P0．05)；IL-6水平在无并发症组和并发症组中位数分别为：4．25 (0．00～75．00)pg／ml和7．5(0．00～48．00)pg／ml，P0．05；Logistic单因素回归分析表明，增高的 CRP、IL-6水平、糖尿病和靶血管AHA／ACC分型是术中急性血管并发症的预测因素。结论 PCI术 前增高的CRP、IL-6水平可能与术中急性血管事件的发生率相关。 【关键词】经皮冠状动脉介入治疗；C反应蛋白；白细胞介素一6；血管并发症；冠脉事件 PrognG61ic value of elevated baseline C-reactive protein and interleukin-6 levels on the vsscl1]sr c0脚 -ca ns in percutaneous coronary intervention WANG Hui，YANG Zhi-jian，HUANG Jun，MA Gen- shah，ZHU Tie-bing，WANG Lian-sheng，CAO Ke-jio~．Department ofCardiology，the First Affaia~a Hospital， 舭晒垤 Medical University，舭 垤 210029，China 【Abstract】Objective To investigate whether elevated pre-proeedural C-reactive protein(CRP)and Interleukin-6(IL-6)concentrations may be relevant to early outcome in patients undergoing PCI．Method 100 consecutive patients undergoing pereutaneuous coronary intervention(PCI)were included in our study．Peripheral blood samplesforCRPandIL-6testing werewithdrawn before PCI．Acute vascular complications resultedfrom PC1 were determined by subsequently coronary angiography．The early coronary events during hospitalization were clinically followed ．Results Thirty patients developed acute vessel occlusion，and another one developed subacute coronary thrombosis at 2 days after PCI．Increased levels of CRP correlated well with the occurrence of vascular comphcations as regards the significant difference existing among I VS Ill and I VSⅣqllal