血清谷氨酰转移酶水平与支架内再狭窄患者炎症反应及血管新生的关系
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摘要
目的研究血清谷氨酰转移酶(GGT)水平与支架内再狭窄患者炎症反应及血管新生的关系。方法选取2015年1月～2017年1月于广西医科大学第二附属医院接受经皮冠状动脉介入治疗(PCI)的急性冠脉综合征患者131例为研究对象。对所有患者均进行为期12个月的随访,根据随访结果将其分为支架内再狭窄组12例与无狭窄组119例。分别比较两组手术前与手术后24 h血清GGT水平,各项炎症指标:C反应蛋白(CRP)、γ-干扰素(IFN-γ)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)以及白细胞介素-18(IL-18);以及血管新生相关指标:血管内皮生长因子(VEGF)、血管生成素1(Ang-1)以及血管生成素2(Ang-2)水平,并作血清GGT与炎症因子、血管新生指标的相关性分析。结果再狭窄组多支病变发生率高于无再狭窄组(P均<0.05)。术后两组的血清GGT、CRP、IFN-γ、IL-6、IL-8以及IL-18水平均明显高于术前,且再狭窄组又高于无再狭窄组,差异均有统计学差异(P均<0.05)。术后两组的VEGF、Ang-1以及Ang-2水平均分别明显低于术前,且再狭窄组又明显低于无再狭窄组,差异均有统计学意义(P均<0.05)。经Pearson相关性分析可得,血清GGT与各项炎症因子均呈正相关,与血管新生指标均呈负相关(P均<0.05)。结论血清GGT水平升高可预测PCI术后支架内再狭窄的发生,与炎症反应及抑制血管新生密切相关,可能是参与支架内再狭窄的重要机制。
Objective To study the relationship among level of serum glutaminyl transferase(GGT), inflammatory response and angiogenesis in patients with stent restenosis. Methods The patients with acute coronary syndrome(ACS) undergone PCI(n=131) were chosen from the Second Affiliated Hospital of Guangxi Medical University from Jan. 2015 to Jan. 2017. All patients were followed up for 12 months, and they were divided into restenosis group(n=12) and non-restenosis group(n=119) according to results of follow-up. The level of GGT before and 24 h after PCI, inflammatory indexes including C-reactive protein(CRP), interferon-γ(IFN-γ), interleukin-6(IL-6), IL-8 and IL-18,and indexes related to angiogenesis including vascular endothelial growth factor(VEGF), angiopoietin-1(Ang-1) and Ang-2 were compared between 2 groups before and 24 h after PCI. The correlation among serum GGT, inflammatory factors and angiogenesis indexes were analyzed. Results The incidence of multi-vessel lesions was higher in restenosis group than that in non-restenosis group(all P<0.05). The levels of GGT, CRP, IFN-γ, IL-6, IL-8 and IL-18 increased significantly in 2 groups after PCI, and were higher in restenosis group than those in non-restenosis group(all P<0.05). The levels of VEGF, Ang-1 and Ang-2 were decreased significantly after PCI, and were lower significantly in restenosis group than those in non-restenosis group(all P<0.05). The results of Pearson correlation analysis showed that serum GGT was positively correlated to all inflammatory factors, and negatively correlated to angiogenesis indexes(all P<0.05). Conclusion The increase of serum GGT level can indict the occurrence of stent restenosis after PCI, which is correlated to inflammatory response and angiogenesis inhibition and may be an important mechanism involved in stent restenosis.
Objective To study the relationship among level of serum glutaminyl transferase(GGT), inflammatory response and angiogenesis in patients with stent restenosis. Methods The patients with acute coronary syndrome(ACS) undergone PCI(n=131) were chosen from the Second Affiliated Hospital of Guangxi Medical University from Jan. 2015 to Jan. 2017. All patients were followed up for 12 months, and they were divided into restenosis group(n=12) and non-restenosis group(n=119) according to results of follow-up. The level of GGT before and 24 h after PCI, inflammatory indexes including C-reactive protein(CRP), interferon-γ(IFN-γ), interleukin-6(IL-6), IL-8 and IL-18,and indexes related to angiogenesis including vascular endothelial growth factor(VEGF), angiopoietin-1(Ang-1) and Ang-2 were compared between 2 groups before and 24 h after PCI. The correlation among serum GGT, inflammatory factors and angiogenesis indexes were analyzed. Results The incidence of multi-vessel lesions was higher in restenosis group than that in non-restenosis group(all P<0.05). The levels of GGT, CRP, IFN-γ, IL-6, IL-8 and IL-18 increased significantly in 2 groups after PCI, and were higher in restenosis group than those in non-restenosis group(all P<0.05). The levels of VEGF, Ang-1 and Ang-2 were decreased significantly after PCI, and were lower significantly in restenosis group than those in non-restenosis group(all P<0.05). The results of Pearson correlation analysis showed that serum GGT was positively correlated to all inflammatory factors, and negatively correlated to angiogenesis indexes(all P<0.05). Conclusion The increase of serum GGT level can indict the occurrence of stent restenosis after PCI, which is correlated to inflammatory response and angiogenesis inhibition and may be an important mechanism involved in stent restenosis.
引文
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[6]周成庭,岳文胜,成阳洋,等.无创性超声测定冠状动脉支架术后再狭窄患者血管内皮功能和循环内皮祖细胞水平[J].中华医学超声杂志(电子版),2016,13(6):424-9.
[7]王芳,丁小云,吕果,等.PCI术后血清S1P和STIM1含量对支架内再狭窄的预测价值及其与血管新生、炎症反应的相关性[J].海南医学院学报,2017,23(13):1798-1800+1804.
[8]李玲,张改,林平,等. PCI术后患者体力活动状况与术后再狭窄的关系研究[J].中华现代护理杂志,2016,22(30):4307-10.
[9]刘英炜,孙津津,张海涛,等.血栓弹力图评估抗血小板药物疗效对冠状动脉支架术后支架内再狭窄的影响[J].中华老年多器官疾病杂志,2015,14(5):347-51.
[10]张改,陈巍,林平,等.经皮冠状动脉介入治疗术后再狭窄的相关因素分析[J].中华护理杂志,2015,50(10):1194-8.
[11]郭志勇,吉斐,张志衡,等.常温机械灌注改善临床心脏死亡供肝功能的可行性及机制[J].中华重症医学电子杂志,2017,3(2):110-06.
[12]吕海燕,王沁,张曦,等.肿瘤坏死因子α和白介素6及核因子κB在酒精性肝病患者血清中的表达及意义[J].中国全科医学,2011,14(21):2405-7.
[13]卫娇娜,杨睿海,王永进,等. PCI术后支架内再狭窄患者血清中谷氨酰转移酶及C反应蛋白与血管新生、炎症反应的相关性[J].海南医学院学报,2017,23(10):1344-7.
[14]刘凯,夏豪,胡丽丽,等.血浆GGT水平与PCI术后支架内再狭窄的相关性研究[J].内科急危重症杂志,2011,17(5):279-81.
[15]金鹏,李琳,胡新荣,等.替格瑞洛与氯吡格雷对急性冠状动脉综合征患者PCI术后血小板功能、炎症因子及长期预后影响的对比分析[J].中国合理用药探索,2017,14(7):5-8.
[16]张俊峰,曹爱芝,李征,等.瑞舒伐他汀对行经皮冠状动脉介入治疗的急性冠状动脉综合征患者术后炎症反应及冠脉再狭窄的影响[J].实用临床医药杂志,2017,21(13):154-6.
[17]郭艳霞,陆士奇,何磊磊,等.急性心肌梗死患者γ-G G T水平与冠状动脉无复流的相关性分析[J].浙江临床医学,2015,18(9):1494-5.
[18]易婷婷,罗光成,李君安,等.4110例无症状高尿酸血症体检者的血常规和γ-谷氨酰转移酶分析[J].中国实验诊断学,2016,20(11):1868-71.
[2]杨鹏杰,韩学斌,朱利军,等.无保护左主干和/或三支病变患者不同血运重建方式预后分析[J].中华胸心血管外科杂志,2017,33(5):306-8.
[3]周寒松,胡有东,张枫林,等. Toll样受体3~4、果糖胺和糖化血红蛋白对老年陈旧性心肌梗死患者冠脉支架置入术后再狭窄和再闭塞的预测[J].中华老年医学杂志,2017,36(7):730-4.
[4]中华医学会心血管病学分会.非ST段抬高急性冠状动脉综合征诊断和治疗指南[J].中华心血管病杂志,2012,40(5):353-67.
[5]龚福汉,刘浙波,夏豪,等.经皮冠状动脉介入术后支架内再狭窄的相关危险因素分析[J].中华实用诊断与治疗杂志,2017,31(5):461-3.
[6]周成庭,岳文胜,成阳洋,等.无创性超声测定冠状动脉支架术后再狭窄患者血管内皮功能和循环内皮祖细胞水平[J].中华医学超声杂志(电子版),2016,13(6):424-9.
[7]王芳,丁小云,吕果,等.PCI术后血清S1P和STIM1含量对支架内再狭窄的预测价值及其与血管新生、炎症反应的相关性[J].海南医学院学报,2017,23(13):1798-1800+1804.
[8]李玲,张改,林平,等. PCI术后患者体力活动状况与术后再狭窄的关系研究[J].中华现代护理杂志,2016,22(30):4307-10.
[9]刘英炜,孙津津,张海涛,等.血栓弹力图评估抗血小板药物疗效对冠状动脉支架术后支架内再狭窄的影响[J].中华老年多器官疾病杂志,2015,14(5):347-51.
[10]张改,陈巍,林平,等.经皮冠状动脉介入治疗术后再狭窄的相关因素分析[J].中华护理杂志,2015,50(10):1194-8.
[11]郭志勇,吉斐,张志衡,等.常温机械灌注改善临床心脏死亡供肝功能的可行性及机制[J].中华重症医学电子杂志,2017,3(2):110-06.
[12]吕海燕,王沁,张曦,等.肿瘤坏死因子α和白介素6及核因子κB在酒精性肝病患者血清中的表达及意义[J].中国全科医学,2011,14(21):2405-7.
[13]卫娇娜,杨睿海,王永进,等. PCI术后支架内再狭窄患者血清中谷氨酰转移酶及C反应蛋白与血管新生、炎症反应的相关性[J].海南医学院学报,2017,23(10):1344-7.
[14]刘凯,夏豪,胡丽丽,等.血浆GGT水平与PCI术后支架内再狭窄的相关性研究[J].内科急危重症杂志,2011,17(5):279-81.
[15]金鹏,李琳,胡新荣,等.替格瑞洛与氯吡格雷对急性冠状动脉综合征患者PCI术后血小板功能、炎症因子及长期预后影响的对比分析[J].中国合理用药探索,2017,14(7):5-8.
[16]张俊峰,曹爱芝,李征,等.瑞舒伐他汀对行经皮冠状动脉介入治疗的急性冠状动脉综合征患者术后炎症反应及冠脉再狭窄的影响[J].实用临床医药杂志,2017,21(13):154-6.
[17]郭艳霞,陆士奇,何磊磊,等.急性心肌梗死患者γ-G G T水平与冠状动脉无复流的相关性分析[J].浙江临床医学,2015,18(9):1494-5.
[18]易婷婷,罗光成,李君安,等.4110例无症状高尿酸血症体检者的血常规和γ-谷氨酰转移酶分析[J].中国实验诊断学,2016,20(11):1868-71.