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

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,探讨其与冠心痛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.

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

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.