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五聚体蛋白3是支架诱导的炎症和新生内膜增厚的一种新型标志物。

Pentraxin3 is a novel marker for stent-induced inflammation and neointimal thickening.

作者信息

Kotooka Norihiko, Inoue Teruo, Fujimatsu Daisuke, Morooka Toshifumi, Hashimoto Shigemsa, Hikichi Yutaka, Uchida Toshihiko, Sugiyama Akira, Node Koichi

机构信息

Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, Saga, Japan.

出版信息

Atherosclerosis. 2008 Mar;197(1):368-74. doi: 10.1016/j.atherosclerosis.2007.05.031. Epub 2007 Jul 19.

Abstract

Inflammation in the injured vessel wall plays an essential role in the mechanism of restenosis. Pentraxin3 (PTX3) is synthesized at the inflammatory site in response to primary inflammatory stimuli. To establish the clinical significance of plasma PTX3 levels in the pathophysiology of inflammation in the injured vessels, we serially measured the levels in 20 patients undergoing elective coronary stenting. Plasma PTX3 levels increased 15 min after coronary stenting, and reached a maximum at 24h in the coronary sinus (P<0.001 versus baseline) and peripheral blood (P<0.001 versus baseline). The transcardiac gradient of PTX3 at 15 min after PCI was higher in patients with than those without restenosis (0.40+/-0.64 versus -0.19+/-0.33 ng/ml, P=0.02). Furthermore, the increase in PTX3 at 24h was positively correlated with the increase in activated Mac-1 on the surface of neutrophils at 48 h (r=0.48, p<0.05) in the coronary sinus. Stepwise multiple regression analysis demonstrated that the relative increase in PTX3 at 24h was the most powerful predictor of late lumen loss (r=0.547, P=0.007). Coronary stenting enhanced circulating PTX3 levels in association with an inflammatory response. PTX3 may be a useful marker for evaluation of inflammatory reaction and neointimal thickening after vascular injury.

摘要

损伤血管壁中的炎症在再狭窄机制中起重要作用。五聚体3(PTX3)在炎症部位响应原发性炎症刺激而合成。为了确定血浆PTX3水平在损伤血管炎症病理生理学中的临床意义,我们连续测量了20例接受择期冠状动脉支架置入术患者的PTX3水平。冠状动脉支架置入术后15分钟血浆PTX3水平升高,并在24小时时在冠状窦(与基线相比P<0.001)和外周血(与基线相比P<0.001)达到最高值。PCI术后15分钟时,有再狭窄患者的PTX3跨心脏梯度高于无再狭窄患者(0.40±0.64对-0.19±0.33 ng/ml,P=0.02)。此外,冠状窦中24小时时PTX3的升高与48小时时中性粒细胞表面活化的Mac-1的增加呈正相关(r=0.48,p<0.05)。逐步多元回归分析表明,24小时时PTX3的相对升高是晚期管腔丢失的最有力预测指标(r=0.547,P=0.007)。冠状动脉支架置入术与炎症反应相关,可提高循环PTX3水平。PTX3可能是评估血管损伤后炎症反应和新生内膜增厚的有用标志物。

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