CD36在冠状动脉成形术后再狭窄中临床意义.docVIP

CD36在冠状动脉成形术后再狭窄中临床意义【摘要】 目的 探讨CD36与冠脉支架介入治疗术后冠状动脉再狭窄的关系。方法 选择308例行冠脉支架置入术的冠心病患者，分别于术前, 术后1个月, 6个月, 采用ELISA 法检测患者血清CD36、C反应蛋白(CRP)、VCAM-1的表达水平。按照冠状动脉狭窄评分(CSA) 标准, 将29例支架术后再狭窄患者分为A、B、C 3组。结果 与术前比较，冠心病患者术后1 个月, 6 个月的CD36、CRP、VCAM-1水平均有显著降低；与术后未狭窄组比较，术后再狭窄组上述指标则明显增高；CD36、CRP、VCAM-1水平随CSA评分的升高而升高；CD36、CRP、VCAM-1与术后再狭窄呈正相关性。结论 CD36、CRP、VCAM-1与支架术后冠状动脉再狭窄形成有一定的相关性，对其表达水平的检测有助于冠脉支架术后临床疗效的评价。? 【关键词】 CD36；冠状动脉狭窄；VCAM-1；C反应蛋白 ?? Effects of CD36 on in-stent restenosis in coronary artery LIN Zhao-de, ZOU Jun, HUANG Jing-wen, et al.Affiliated Nanhai Hospital of Southern Medical University， Fosham 528200,China ? 【Abstract】 Objective To study the effect of CD36 on coronary artery restenosis after coronary artery stent interpolation (CASI). Methods Three hundred and eight patients with coronary artery disease received CASI. Hematology levels of CD36, CRP, VCAM-1of all 308 patients were measured by enzyme-linked immunosorbent assay (ELISA), respectively, before,1 and 6 months after CASI. According to CSA criteria, 29 cases of coronary artery restenosis after CASI were classified into group A, group B and group C. Results Compared with the values before the interventional therapy, hematology levels of CD36, CRP, VCAM-1 among the selected patients, without exception, decreased significantly 1 month and 6 months after CASI. In the cases o f post-CASI coronary artery restenosis, the previously mentioned corresponding items increased evidently, and the values were positively correlated with CSA grade and severity of CAD. Conclusion CD36, CRP, VCAM-1 are related to coronary artery restenosis after CASI. The measurement of hematology levels of it is some value in the prognosis of coronary artery restenosis.? 【Key words】 CD36; Coronary stenosis；VCAM-1；CRP CD36是一种在单核细胞、巨噬细胞、平滑肌细胞以及脂肪细胞高度表达的清道夫受体, 是氧化型低密度脂蛋白的高亲和力受体[1]。国内外研究发现，CD36通过介导单核细胞粘附、泡沫细胞的形成和炎症等参与粥样斑块的进展，与斑块的不稳定性有关，可促进斑块破裂的发生[2-5]。内皮细胞损伤后血管细胞粘附分子(VCAM-1)、C反应蛋白(CRP)的表达增强，与粥样斑块的进展密切相关[6]。? 经皮冠状动脉介入治疗(PCI)