血管性血友病因子对支架术后冠状动脉内皮化的预测价值
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The Value of von Willebrand Factor in Predicting Endothelialization After Coronary Stent Implantation
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    目的探讨血管性血友病因子(vWF)对冠状动脉支架植入术后冠状动脉内皮化的预测价值以及对ADP受体拮抗剂用药时间的指导意义。方法对冠状动脉支架植入治疗后12~18个月无症状的冠心病患者进行冠状动脉造影复查,造影后对无支架内再狭窄的30例患者的32支血管34个支架进行光学相干断层成像(OCT)检查,根据成像结果分组,支架小梁完全内皮化的患者为完全内皮化组,支架小梁非完全内皮化的患者为非完全内皮化组,选18例冠状动脉造影显示血管无狭窄的患者为对照组,术后抽取肘静脉血,测定vWF水平。结果非完全内皮化组血浆vWF水平显著高于完全内皮化组和正常对照组(29.13±8.47 μg/L比13.81±1.04 μg/L和12.83±1.13 μg/L,p<0.05),完全内皮化组血浆vWF因子水平与正常对照组比较无显著性差异(p>0.05)。结论vWF对预测冠状动脉支架植入术后冠状动脉内皮化有一定的参考价值,对临床ADP受体拮抗剂用药时间有一定的指导意义。

    Abstract:

    AimTo investigate whether von Willebrand factor (vWF) can predict endothelialization after coronary stent implantation.MethodsOptical coherence tomography (OCT) images were obtained in 32 diseased coronary vessels with 34 stents in 30 patients with coronary artery disease who had no restenosis on follow up angiography at 12~18 months post drug-eluting stent (DES).Patients with complete endothelialization of the struts were considered as complete endothelialization group, patients with incomplete endothelialization of the DES struts were considered as incomplete endothelialization group, patients with angiographily diagonased nomal coronary were selected as the control group.For all the patients blood was drawed from elbow venous after operation, then plasma vWF levels of the three groups were tested.ResultsThe plasma vWF levels of incomplete endothelialization group were significantly higher than the complete endothelialization group and the control group (29.13±8.47 μg/L vs 13.81±1.04 μg/L and 12.83±1.13 μg/L,p<0.05), the plasma vWF levels had no significant difference in the complete endothelialization group and the control group (p>0.05).ConclusionsOur study confirms that the plasma vWF level has certain reference value in predicting endothelialization after coronary stent implantation.To some extent, the plasma vWF level can guide how long the antiplatelet therapy should be continued for the patients with coronary artery disease who had DES implanted.

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刘燕,王彦富,李祥廷,赵家琦,孙景芝,张慧玲,吴德光,靳奇峰,陈园园,李清贤.血管性血友病因子对支架术后冠状动脉内皮化的预测价值[J].中国动脉硬化杂志,2012,20(11):1017~1020.

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  • 收稿日期:2012-01-05
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