Li Jian-Jun, Fang Chun-Hong, Jiang Hong, Huang Cong-Xin, Hui Ru-Tai, Chen Ming-Zhe
Renmin Hospital, Wuhan University School of Medicine, Wuhan 430060, PR China.
Clin Chim Acta. 2004 Dec;350(1-2):115-21. doi: 10.1016/j.cccn.2004.07.013.
Inflammatory response has been demonstrated in patients with coronary artery disease after percutaneous coronary intervention (PCI). Such response following renal artery stenting has not yet been established, however, in patients with atherosclerotic renal artery stenosis.
A total of 44 patients were enrolled in this study. Of them, 22 patients with atherosclerotic renal artery stenosis received renal angioplasty with stent (group A, mean age 51+/-8 years), and 22 patients with age- and gender-matched underwent renal angiography for diagnostic purpose as a control group (group B, age 50+/-8 years). The peripheral blood samples were taken immediately before the procedure, 1, 6 and 24 h after the procedure in both groups. The concentrations of C-reactive protein (CRP) and interleukin-6 (IL-6) were measured using ELISA.
The result showed that there was no difference in clinical characteristics and baseline levels of CRP and IL-6 between the groups. The IL-6 increased in the first hour (before: 5.8+/-3 pg/ml; 1 h: 8.6+/-5 pg/ml, p<0.01), lasted at 6 h (12.2+/-8 pg/ml), returned to baseline at 24 h (5.4+/-3 pg/ml) in group A. The CRP did not changed at the first hour after stenting, but mean CRP increased from 0.30+/-0.09 to 0.37+/-0.15 mg/dl at 6 h (p<0.05), and peaked at 24 h (0.43+/-0.18 mg/dl, p<0.001 compared with baseline and control) after stenting in group A, while no such changes were observed in group B (p>0.05 at different time points compared with baseline and group B, respectively).
The data indicated that renal artery stenting could trigger inflammatory response by evidence of increased plasma levels of CRP and IL-6. IL-6, however, was an early initiator of inflammatory cytokine, and CRP was a later marker of systemic inflammatory response to renal artery stenting.
经皮冠状动脉介入治疗（PCI）后，冠状动脉疾病患者体内已证实存在炎症反应。然而，对于动脉粥样硬化性肾动脉狭窄患者，肾动脉支架置入术后的此类反应尚未得到证实。
本研究共纳入44例患者。其中，22例动脉粥样硬化性肾动脉狭窄患者接受了肾血管成形术并置入支架（A组，平均年龄51±8岁），另外22例年龄和性别匹配的患者接受肾血管造影检查以作诊断对照（B组，年龄50±8岁）。两组均在术前、术后1小时、6小时和24小时采集外周血样本。采用酶联免疫吸附测定法（ELISA）检测C反应蛋白（CRP）和白细胞介素-6（IL-6）的浓度。
结果显示，两组患者的临床特征以及CRP和IL-6的基线水平无差异。A组中，IL-6在术后第1小时升高（术前：5.8±3 pg/ml；1小时：8.6±5 pg/ml，p<0.01），在6小时时维持在该水平（12.2±8 pg/ml），24小时时恢复至基线水平（5.4±3 pg/ml）。CRP在支架置入术后第1小时未发生变化，但在6小时时平均CRP从0.30±0.09 mg/dl升高至0.37±0.15 mg/dl（p<0.05），并在术后24小时达到峰值（0.43±0.18 mg/dl，与基线和对照组相比p<0.001），而B组未观察到此类变化（与基线和B组相比，不同时间点p>0.05）。
数据表明，肾动脉支架置入术可通过血浆CRP和IL-6水平升高证明引发炎症反应。然而，IL-6是炎症细胞因子的早期启动因子，而CRP是肾动脉支架置入术后全身炎症反应的后期标志物。
