动脉硬化闭塞症患者介入治疗后ET-1、T/P(TXA2/PGI2)的变化及其与血管病变程度的关系

Changes of blood plasma ET-1 and T/P(TXA2/PGI2) and their relationship with vascular lesions in patients with arteriosclerosis obliterans before and after the interventional therapy

摘要:

目的：探讨下肢动脉硬化闭塞症(Arteriosclerosis obliterans,ASO)患者介入治疗后血浆内皮素-1(Endothelin-1,ET-1)、血栓素A2(Thromboxane A2,TXA2)、前列环素I2(Prostacyclin I2,PGI2)及TXA2/PGI2值(TXA2/PGI2,T/P)变化及其与血管病变程度的关系。方法：42例ASO患者按泛大西洋协作组(Transatlantic inter society consensus,TASC)指南分期分为A、B、C组，用酶联免疫吸附法(Enzyme-linked immunosorbent assay,ELISA)检测患者腔内介入治疗前后血浆ET-1、TXA2、PGI2水平，计算T/P值。结果：各组患者术后血浆ET-1、T/P值都有升高，差异均有统计学意义(F=44.34,P<0.01;F=109.09,P<0.01)。B组、C组ET-1在术前、术后均高于A组，差异均有统计学意义(P<0.05)；T/P值在A组、B组、C组两两比较中差异均存在统计学意义(P<0.05)，随TASC分期增高而升高。术后T/P值与术后PGI2 值呈负相关性(r=-0.638，P<0.01)，与术后TXA2值无相关性(r=0.099，P>0.05)。结论：ASO患者介入治疗术后血浆ET-1、T/P值进一步升高，内皮细胞损害是主要的原因；ET-1、T/P值及T/P差值随血管病变程度加重而升高；血管病变程度越严重，术后血栓形成几率越高。

Abstract:

Objective:To investigate the changes of blood plasma endothelin-1(ET-1), thromboxane A2(TXA2), prostacyclinI2(PGI2) and TXA2/PGI2(T/P) as well as their relationship with vascular lesions in patients with ateriosclerosis obliterans(ASO) before and after interventional therapy. Methods:Totally 42 cases with ASO were divideed into group A, B and C based on transatlantic inter society consensus(TASC). The levels of ET-1, TXA2 ,PGI2in plasma in all cases were measured by method of enzyme-linked immunosorbent assay (ELISA) before and after interventional treatment, then the value of T/P were calculated. Results: The levels of ET-1, T/P were increased in all groups after interventional therapy compared with those before the operation with statistical differences(F=44.34, P<0.01; F=109.09, P<0.01). The level of ET-1 in group B and C before and after the operation was significant higher than in group A with statistical differences(P<0.05). Statistical differences was observed in the value of T/P between group A, B and C(P<0.05). The value of T/P was increased as the vascular lesion become more and more severe. Negative correlation was obseved between postoperative T/P value and postoperative PGI2 value (r=-0.638, P<0.01) while no correlation was found between postoperative T/P value and postoperative TXA2 value(r=0.099，P>0.05). Conclusion: The levels of ET-1 and T/P in blood plasma are incresed in patients with ASO after all interventional therapy, the cause of which is the damage of endothelial cell. The levels of ET-1,T/P and the changes of T/P value are incresed as the vascular lesion become more and more severe. The formation of postoperative thrombus is positively associated with the severity of vascular lesion.