介入治疗对急性冠脉综合征患者炎症反应及血小板活性的影响.docVIP

介入治疗对急性冠脉综合征患者炎症反应及血小板活性的影响 ????　　[摘要] 目的:观察急性冠脉综合征患者冠脉介入治疗术前、术后炎症介质IL-6、hsCRP水平及血小板活性指标CD62p、CD63的改变。方法:58例急性冠脉综合征患者在冠脉介入术前30 min,术后2、24、72、96 h分别检测炎症介质IL-6、hs-CRP和血小板功能活性指标CD62p、CD63水平。hs-CRP测定采用乳胶增强免疫散射比浊法,IL-6测定采用双抗体夹心酶联免疫吸附法(ELISA),流式细胞仪测定CD62p、CD63水平。选择53例冠状动脉造影结果正常者作对照,观察冠脉介入前后指标的变化并与对照组比较。结果:与对照组比,急性冠脉综合征组IL-6、hs-CRP、CD62p、CD63明显增高(P0.05);急性冠脉综合征患者介入术后2、24、72 h IL-6、hs-CRP、CD62p、CD63水平与术前相比明显增高(P0.05),在术后24 h达峰值,术后72 h降低,术后96 h恢复到术前水平(P0.05)。结论:血小板活化和炎症反应在急性冠脉综合征发生和发展过程中起重要作用,冠脉介入治疗激活急性冠脉综合征患者血小板活性因子及炎症反应因子。 　　[关键词] 急性冠状动脉综合征; 冠脉介入治疗; 炎症反应; 血小板活化 　　Effect of percutaneous coronary intervention on inflammatory reactions  　　and platelet activation in patients with acute coronary syndrome  [Abstract] Objective: To observe the changes of serum level of inflammatory mediators IL-6, hsCRP and platelet activity index CD62p, CD63 before and after percutaneous coronary intervention(PCI) in patients with acute coronary syndrome(ACS). Methods: The blood was collected respectively at 30 min before PCI and 2, 24, 72, 96 h after PCI in 58 patients with ACS and control group. The serum levels of the CD62p, CD63 were assayed by flow cytometry, the hs-CRP was measured by immune scatter turbidimetry and IL-6 was analyzed by enzyme linked immunosorbent assay(ELISA). Results: The IL-6, hs-CRP, CD62p, CD63 levels in the patients with ACS increased significantly compared with control group(P0.05), and those indices at 2, 24 and 72 h group increased significantly compared with pre-PCI group(P0.05). Those indices peaked at 24 h after PCI, declined at 72 h after PCI, and recovered to pre-PCI level at 96 h(P0.05). Conclusion: Platelet activation and inflammatory reactions play an important role in the occurrence and development of ACS. PCI may activate platelet activation and inflammatory reactions factors in patients with ACS. 　　[Key words] acute coronary syndrome; percutaneous coronary intervention; inflammatory reactions; platelet activation 　　 　　急性冠脉综合征(acute coronary syn