摘要
目的 探讨经皮冠状动脉介入 (PCI)治疗术前增强的炎症反应对术中及围术期血管并发症的预测价值。方法 连续选择 10 0例冠状动脉内支架植入术患者 ,于术前留取外周血标本 ,分离出周围血单核细胞 (PBMCs)并提取核蛋白 ;采用凝胶电泳迁移率实验 (EMSA)测定PBMCs中NF κB活性表达 ,ELISA法测定白细胞介素 6 (IL 6 )水平 ;通过冠状动脉造影等影像学和临床指标判定PCI术中及围术期血管并发症。结果 10 0例患者中 ,13例于术中发生急性管腔闭塞 ,1例于术后 2d发生亚急性血栓 ,均于闭塞处行PTCA和 或支架植入 ,恢复TIMI 3级血流。余 86例术中无血管并发症发生 ;术后 30d临床随访 ,无缺血性事件及各种原因的死亡发生。NF κB活性在血管并发症组和无并发症组分别为 (2 11± 0 6 1)倍和 (1 30±0 4 2 )倍 ,P <0 0 1;IL 6水平两组分别 4 2 5 (0 0 0～ 75 0 0 )pg ml和 7 5 (0 0 0～ 4 8 0 0 )pg m ,P <0 0 5。Logistic回归分析表明 ,增高的NF κB水平、糖尿病和靶血管AHA ACC分型是血管并发症的独立预测因素。结论 PCI术前增高的炎症反应可能与血管并发症相关。
Objective To investigate the value of pre-procedural elevated nuclear factor-κB (NF-κB) activation and interleukin-6 (IL-6) concentration in predicting the risk of vascular complications in percutaneuous coronary intervention (PCI). Methods One hundred consecutive patients undergoing PCI were included in our study. Pre-procedural NF-kB activation in peripheral blood mononuclear cells(PBMCs) was determined by electromobility shift assays (EMSA). Acute or subacute vascular complications resulting from PCI were determined mainly by subsequently coronary angiography.Results Thirteen patients developed acute vessel occlusion, and another one developed subacute coronary thrombosis at 2 day after PCI.Activity of NF-κB in vascular complication or non-vascular complication groups were (2.11±0.61) fold and (1.30±0.42)fold,respectively,P<0.01.Levels of IL-6 in these two groups were 4.25(0.00-75.00) pg/ml and 7.5(0.00-48.00) pg/m,respectively,P<0.05. Logistic regression analysis showed NF-κB activity was an independent powerful predictor of the early outcome of PCI. Conclusion Pre-procedural elevated inflammatory markers may be associated with the vascular complications in patients of PCI.
出处
《中华急诊医学杂志》
CAS
CSCD
2004年第10期691-693,共3页
Chinese Journal of Emergency Medicine
