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Study Of Restenosis After Coronary Artery Intervention And Relevance Cell Factor

Posted on:2007-09-22Degree:MasterType:Thesis
Country:ChinaCandidate:J L GongFull Text:PDF
GTID:2144360182996308Subject:Internal Medicine
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At present, Coronary atherosclerotic heart disease (coronaryheart disease) is prevalent in many countries and is the major causeof death. Coronary artery intervention (PCI) has become animportant means in curing CHD. Restenosis after percutaneouscoronary artery intervention (PCI) has been major problem, and hasinfluenced patient's health. From pathology physiology, we canknow restenosis is prevalent in PCI. Recent studies showedrestenosis in PCI is relevant with patients' age, sex, conditions anddegree of disease, smoking, company other disease, level ofoperator, and so on. We still don't know specific mechanism ofrestenosis.During restenosis growth, vascular remodeling, endothelial celland smooth muscle cell proliferate, damage degree of middlemembrane and vascular remodeling, has played an importantfunction. PCI cause vascular endothelial cell's damage in coronaryartery, lead to release relevance cell factor and result in restenosis.This study purpose is know mechanism of restenosis after PCI inCHD;so that solution restenosis.Method: 50 patients who come from The Chang Chun centralHospital from July of 2004 to July of 2005 were divided into threegroups. Group A consisted of 15 healthy cases (were verified bycoronary arterial radiaography, their coronary were smooth andblood speed were normal) were choose from random. It included10 male cases and 5femal cases whose average age was 56.32±8.72(35-58). Group A was blooded for one time after coronary arterialradiography. Group B consist of 15 patients who had coronaryatherosclerosis (coronary stenosis > 50% < 70%). Group Bincluded 10male cases and 5 female cases whose average age was55.60±8.71 (46-73). They don't cure in PCI. Group C consist of 20patients who have coronary heart disease (coronary stenosis≥70%)were verified by coronary arterial radiaography and have beensuccessful PTCA + stent case. Group C included 14 male cases and6 female cases whose average age was 58.73±8.68(42-70), withstenting 31 included 6cases single condition and 14 cases complexcondition. Patients of Group B and Group C were blooded 6 ml(measure ET-1, PDGF, TNF) coronary venous sinus separatelybefore and after operation. ET-1 and TNF were measured byradiation and immunity analytic method. PDGF was measured byenzyme immunity analytic method.Result: 1. Group of coronary heart disease (Group B, Group C),ET-1 before operation (95.23±18.16 , 98.89±21.26);PDGF(928.17±173.18 , 935.88±125.35);and TNF (25.00±13.30 ,27.12±10.77) were obviously higher than group A (ET-1 为49.56±20.79;PDGF 为 273.42±27.05;TNF 为 16.6±33.80), P<0.01.2.Plasma in group B after 30 minutes of coronary arterialradiaography , ET-1 ( 99.83±28.55), PDGF (962.17±158.12),TNF (24.85±14.10) weren't change obviously (P>0.05).3. In Group C after 30 minutes of coronary arterialradiaography , ET-1 (123.49±28.27), PDGF (1496.86±235.82),TNF (68.56±23.10) , content become higher obviously after PTCA+stent operation and has statistic sense (P<0.01).EF-1 Unit : ng/L PDGF Unit: pg/ml TNF Unit: pg/mlConclusion: 1. ET-1, PDGF and TNF would contribute toatherosclerosis. 2. Diagnostic coronary arterial radiaography don'tinfluence ET-1, PDGF and TNF content in shortly time. 3. ET-1,PDGF and TNF would result in restenosis after interventiontherapy.
Keywords/Search Tags:Coronary atherosclerotic heart disease (CHD), Percutaneous coronary artery intervention (PCI), Restenosis endothelin-1 (ET-1), platelet-derived growth factor (PDGF), tumor necrosis factor (TNF)
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