Gabbasov Z A, Kozlov S G, Saburova O S, Imaeva A É, Bosykh E G, Liakishev A A, Zykov K A, Masenko V P
Kardiologiia. 2011;51(6):49-54.
Aim of the study was to assess activation of eosinophils as well as allergic and inflammatory reactions of the body in development of restenosis after implantation of stents with drug covering. We included into the study 32 patients with ischemic heart disease (IHD) and stable angina subjected to repeat coronary angiography during first year after endovascular myocardial revascularization with the help of stents with drug covering, and 11 healthy persons. Levels of eosinophilic cation protein (ECP), immunoglobulin E (IgE), and C-reactive protein (CRP) in blood plasma of patients and healthy persons was determined by immunoenzyme assay. According to results of angiographic study patients were divided into 2 groups: the first comprised 19 patients in whom no instent restenosis was found, the second comprised 13 patients in whom formation of restenosis at least in one stent was noted. Patients in these groups did not differ by age, sex, smokers and nonsmokers ratio, presence of hyperlipidemia, and angiographical characteristics of involved arteries. In patients with restenosis of stents blood plasma ECP level was 17.7 (11.2-24.0) g/ml and significantly higher than in patients without restenosis [9.0 (6.4-12.9) g/ml; p=0.017]. Blood level of IgE in these groups of patients did not differ [58.8 (42.1-164.0) and 52.9 (12.8-76.1) mg/ml, respectively; p=0.40] and did not differ from IgE level in blood of healthy volunteers [32.0 (21.2-80.8) mg/ml; p=0.91]. CRP level in patients with IHD was higher than in healthy volunteers [0.36 (0.1-0.75) mg/ml; p=0.0008)], but did not differ significantly in groups of patients with and without restenosis [2.38 (0.30-4.08) and 1.63 (0.61-2.47) mg/ml, respectively; p=0.52]. It was found that in the group of patients with low blood level of ECP (<11 g/ml) restenoses were revealed in 19% while in the group with higher blood level of ECP (>11 g/ml) - in 62% of cases (p=0,019). In patients subjected to coronary stenting with higher level of ECP in blood we noted more frequent development of restenoses than in patients with low level of this protein. The data obtained allow to suggest presence of relationship between development of restenosis and elevated activity of eosinophilic granulocytes in patients with IHD after revascularization.
本研究的目的是评估药物涂层支架植入术后再狭窄形成过程中嗜酸性粒细胞的活化情况以及机体的过敏和炎症反应。我们纳入了32例缺血性心脏病（IHD）和稳定型心绞痛患者，这些患者在接受药物涂层支架血管内心肌血运重建术后的第一年接受了重复冠状动脉造影，还纳入了11名健康人。采用免疫酶法测定患者和健康人血浆中嗜酸性阳离子蛋白（ECP）、免疫球蛋白E（IgE）和C反应蛋白（CRP）的水平。根据血管造影研究结果，患者被分为两组：第一组包括19例未发现支架内再狭窄的患者，第二组包括13例至少在一个支架中发现再狭窄形成的患者。这些组中的患者在年龄、性别、吸烟者与非吸烟者比例、高脂血症的存在以及受累动脉的血管造影特征方面没有差异。在支架再狭窄患者中，血浆ECP水平为17.7（11.2 - 24.0）μg/ml，显著高于无再狭窄患者[9.0（6.4 - 12.9）μg/ml；p = 0.017]。这些组患者的血液IgE水平没有差异[分别为58.8（42.1 - 164.0）和52.9（12.8 - 76.1）mg/ml；p = 0.40]，并且与健康志愿者血液中的IgE水平没有差异[32.0（21.2 - 80.8）mg/ml；p = 0.91]。IHD患者的CRP水平高于健康志愿者[0.36（0.1 - 0.75）mg/ml；p = 0.0008]，但在有和无再狭窄的患者组中没有显著差异[分别为2.38（0.30 - 4.08）和1.63（0.61 - 2.47）mg/ml；p = 0.52]。发现血浆ECP水平低（<11μg/ml）的患者组中，19%出现再狭窄，而血浆ECP水平高（>11μg/ml）的患者组中，62%出现再狭窄（p = 0.019）。在血液中ECP水平较高的接受冠状动脉支架植入的患者中，我们注意到再狭窄的发生比该蛋白水平低的患者更频繁。获得的数据表明，IHD患者血运重建后再狭窄的发生与嗜酸性粒细胞活性升高之间存在关联。
