2022 年第 10 期 第 17 卷

置入生物可吸收支架的冠心病患者 高敏C反应蛋白和脂蛋白相关磷脂酶A2水平变化

Changes of high sensitivity C-reactive protein and lipoprotein-associated phospholipase A2 levels after implantation of bioabsorbable scaffold in patients with coronary atherosclerotic heart disease

作者：崔占前1赵国伟2郭欣君1

英文作者：Cui Zhanqian1 Zhao Guowei2 Guo Xinjun1

单位：1内蒙古自治区人民医院心血管内科，呼和浩特010017；2内蒙古自治区人民医院急诊医学科，呼和浩特010017

英文单位：1Department of Cardiology Inner Mongolia Autonomous Region People′s Hospital Hohhot 010017 China; 2Department of Emergency Inner Mongolia Autonomous Region People′s Hospital Hohhot 010017 China

关键词：冠心病（冠状动脉粥样硬化性心脏病）；生物可吸收支架；高敏C反应蛋白；脂蛋白相关磷脂酶A2；炎症

英文关键词：Coronaryatheroscleroticheartdisease;Bioabsorbablescaffold;HighsensitivityC-reactiveprotein;Lipoprotein-associatedphospholipaseA2;Inflammation

• 摘要：

• 目的 观察置入生物可吸收支架的冠心病（冠状动脉粥样硬化性心脏病）患者高敏C反应蛋白（hs-CRP）、脂蛋白相关磷脂酶A2（Lp-PLA2）水平变化，评价生物可吸收支架临床应用的有效性及安全性。方法 选取2019年6月至2021年1月于内蒙古自治区人民医院心血管内科行经皮冠状动脉介入（PCI）治疗并置入Firesorb生物可吸收支架的81例冠心病患者作为观察组，同时连续选取同期住院行冠状动脉造影检查确认不需要行PCI治疗并完成随访复查的83例冠心病患者作为对照组。比较2组基础临床资料，术前、术后48 h及术后1年的hs-CRP、Lp-PLA2水平，主要不良心血管事件（MACE）发生情况。结果 观察组吸烟史比例、术前hs-CRP、Lp-PLA2水平及左心室射血分数均高于对照组，差异均有统计学意义（P＜0.01或P<0.05）。观察组患者术后48 h hs-CRP、Lp-PLA2水平明显高于术前，术后1年Lp-PLA2水平明显低于术前，差异均有统计学意义（均P＜0.01）。术后1年观察组hs-CRP水平高于对照组［（2.2±0.6）mg/L比（1.5±0.4）mg/L］，差异有统计学意义（t=3.021，P=0.003），Lp-PLA2水平虽高于对照组［（199±48）mmol/L比（190±44）mmol/L］，但差异无统计学意义（t=3.045，P=0.090）。在术后1年的随访中，观察组与对照组MACE发生率比较差异无统计学意义［4.9%（4/81）比3.6%（3/83）］（P=0.718）。结论 置入生物可吸收支架的冠心病患者1年后体内hs-CRP和Lp-PLA2仍处于较高水平，生物可吸收支架可用于冠状动脉病变。

• Objective  To observe the changes of high sensitivity C-reactive protein(hs-CRP) and lipoprotein-associated phospholipase A2(Lp-PLA2) levels in patients with coronary atherosclerotic heart disease who were implanted with bioabsorbable scaffold, and to evaluate the effectiveness and safety of clinical application of bioabsorbable scaffold. Methods Totally 81 patients with coronary atherosclerotic heart disease who underwent percutaneous coronary intervention(PCI) and were implanted with Firesorb bioabsorbable scaffold in Department of Cardiology, Inner Mongolia Autonomous Region People′s Hospital from June 2019 to January 2021 were selected as the observation group, while 83 patients with coronary atherosclerotic heart disease who were hospitalized for coronary angiography and confirmed that PCI was not required and completed follow-up were selected as the control group. The basic clinical data, the levels of hs-CRP, Lp-PLA2 at preoperation, 48 h after operation  and 1 year after operation, and the incidence of major adverse cardiovascular events (MACE) were compared between the two groups. Results The smoking proportion, preoperative hs-CRP, Lp-PLA2 levels and left ventricular ejection fraction in the observation group were higher than those in the control group(P<0.01 or P<0.05). The levels of hs-CRP and Lp-PLA2 in the observation group 48 h after operation were significantly higher than those before operation, and the level of Lp-PLA2 1 year after operation was significantly lower than that before operation(all P<0.01). One year after operation, the level of hs-CRP in the observation group was higher than that in the control group［(2.2±0.6)mg/L vs (1.5±0.4)mg/L］(t=3.021, P=0.003). The level of Lp-PLA2 was higher than that in the control group［(199±48)mmol/L vs (190±44)mmol/L］, while the difference was not statistically significant(t=3.045, P=0.090). During the 1-year follow-up after operation, there was no significant difference in the incidence of MACE between the observation group and the control group［4.9%(4/81) vs 3.6%(3/83)］(P=0.718). Conclusions The levels of hs-CRP and Lp-PLA2 in patients with coronary atherosclerotic heart disease are still at high levels 1 year after implanted with bioabsorbable scaffold. Bioabsorbable scaffold can be used for coronary lesions.