关于PCI术后NCCLs的病变进展与炎症因子、危险因素的研究
Research on the Progression of NCCLs Lesions and the Role of Inflammatory Factors and Risk Factors Following PCI
DOI: 10.12677/acm.2025.1541005, PDF,   
作者: 张国栋*：吉首大学医学院，湖南 吉首；伍 岳*, 向红菊#：吉首大学第一附属医院心血管内科，湖南 吉首
关键词: 冠心病；非罪犯血管病变；冠脉介入治疗技术；C-反应蛋白；淋巴细胞；Coronary Heart Disease； Non-Culprit Coronary Lesions； Percutaneous Coronary Intervention； C-Reactive Protein； Lymphocytes
摘要: 随着冠脉介入治疗技术(Percutaneous Coronary Intervention, PCI)的发展和进步，以及术后新型抗血小板聚集药物和抗凝药物的广泛使用，冠状动脉性心脏病(简称冠心病，coronary heart disease, CHD)患者的临床预后得到显著改善，CHD相关的并发症也显著降低。然而，PCI术后非罪犯血管(non-culprit coronary lesions, NCCLs)病变进展的问题，仍是影响患者长期生存率和预后的重要挑战。因此，深入探讨和解决NCCLs病变进展的机制、病理生理过程、影响因素，并在此基础上制定有效的治疗和预防策略，对进一步改善患者预后，进一步降低死亡率具有一定的临床意义和研究价值。
Abstract: With the advancement and development of percutaneous coronary intervention (PCI) techniques, along with the widespread use of novel antiplatelet and anticoagulant agents postoperatively, the clinical prognosis of patients with coronary heart disease (CHD) has significantly improved, and the incidence of CHD-related complications has markedly decreased. However, the progression of non-culprit coronary lesions (NCCLs) after PCI remains a critical challenge affecting long-term survival and prognosis. Therefore, in-depth exploration of the mechanisms, pathophysiological processes, and influencing factors of NCCLs progression, as well as the development of effective therapeutic and preventive strategies based on these findings, holds significant clinical and research value for further improving patient outcomes and reducing mortality rates.
文章引用：张国栋, 伍岳, 向红菊. 关于PCI术后NCCLs的病变进展与炎症因子、危险因素的研究[J]. 临床医学进展, 2025, 15(4): 857-864. https://doi.org/10.12677/acm.2025.1541005

参考文献

[1] Roth, G.A., Mensah, G.A., Johnson, C.O., et al. (2020) Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update from the GBD 2019 Study. Journal of the American College of Cardiology, 76, 2982-3021.
[2] Dai, H., Much, A.A., Maor, E., Asher, E., Younis, A., Xu, Y., et al. (2020) Global, Regional, and National Burden of Ischaemic Heart Disease and Its Attributable Risk Factors, 1990–2017: Results from the Global Burden of Disease Study 2017. European Heart Journal—Quality of Care and Clinical Outcomes, 8, 50-60. [Google Scholar] [CrossRef] [PubMed]
[3] 刘明波, 何新叶, 杨晓红, 等. 《中国心血管健康与疾病报告2023》要点解读[J]. 中国心血管杂志, 2024, 29(4): 305-324.
[4] Ballou, S.P. and Lozanski, G. (1992) Induction of Inflammatory Cytokine Release from Cultured Human Monocytes by C-Reactive Protein. Cytokine, 4, 361-368. [Google Scholar] [CrossRef] [PubMed]
[5] 解晨曦, 毕波. 脂蛋白相关lncRNA参与炎症反应致冠心病的分子机制[J]. 中西医结合心脑血管病杂志, 2024, 22(2): 326-330.
[6] 王淑莹. PCI术后患者发生非罪犯血管狭窄程度进展的影响因素及列线图模型构建[D]: [硕士学位论文]. 十堰: 湖北医药学院, 2023.
[7] 王小泉, 赵红宇. C反应蛋白基因多态性与牙周炎和冠心病相关性的研究进展[J]. 广东牙病防治, 2012, 20(4): 213-216.
[8] Haverkate, E., Thompson, S.G., Pyke, S.D., Gallimore, J.R. and Group, M.B.P. (1997) Production of C-Reactive Protein and Risk of Coronary Events in Stable and Unstable Angina. The Lancet, 349, 462-466. [Google Scholar] [CrossRef] [PubMed]
[9] Onsrud, M. and Thorsby, E. (1981) Influence of in Vivo Hydrocortisone on Some Human Blood Lymphocyte Subpopulations. Scandinavian Journal of Immunology, 13, 573-579. [Google Scholar] [CrossRef] [PubMed]
[10] Balta, S., Kurtoglu, E., Kucuk, U., Demirkol, S. and Ozturk, C. (2014) Neutrophil-Lymphocyte Ratio as an Important Assessment Tool. Expert Review of Cardiovascular Therapy, 12, 537-538. [Google Scholar] [CrossRef] [PubMed]
[11] Blum, A., Sclarovsky, S., Rehavia, E. and Shohat, B. (1994) Levels of T-Lymphocyte Subpopulations, Interleukin-1β, and Soluble Interleukin-2 Receptor in Acute Myocardial Infarction. American Heart Journal, 127, 1226-1230. [Google Scholar] [CrossRef] [PubMed]
[12] Rose-John, S. (2017) The Soluble Interleukin 6 Receptor: Advanced Therapeutic Options in Inflammation. Clinical Pharmacology & Therapeutics, 102, 591-598. [Google Scholar] [CrossRef] [PubMed]
[13] Aparicio-Siegmund, S., Deseke, M., Lickert, A. and Garbers, C. (2017) Trans-signaling of Interleukin-6 (IL-6) Is Mediated by the Soluble IL-6 Receptor, but Not by Soluble CD5. Biochemical and Biophysical Research Communications, 484, 808-812. [Google Scholar] [CrossRef] [PubMed]
[14] 朱凯瑞. Egr3基因、炎症因子IL-1β、IL-6与冠心病的相关性研究[D]: [硕士学位论文]. 乌鲁木齐: 新疆医科大学, 2022.
[15] Dabravolski, S.A., Bezsonov, E.E., Baig, M.S., Popkova, T.V. and Orekhov, A.N. (2021) Mitochondrial Lipid Homeostasis at the Crossroads of Liver and Heart Diseases. International Journal of Molecular Sciences, 22, Article 6949. [Google Scholar] [CrossRef] [PubMed]
[16] Libby, P. (2021) Targeting Inflammatory Pathways in Cardiovascular Disease: The Inflammasome, Interleukin-1, Interleukin-6 and beyond. Cells, 10, Article 951. [Google Scholar] [CrossRef] [PubMed]
[17] Neumann, F., Ott, I., Marx, N., Luther, T., Kenngott, S., Gawaz, M., et al. (1997) Effect of Human Recombinant Interleukin-6 and Interleukin-8 on Monocyte Procoagulant Activity. Arteriosclerosis, Thrombosis, and Vascular Biology, 17, 3399-3405. [Google Scholar] [CrossRef] [PubMed]
[18] Natsume, M. and Baba, S. (2013) Suppressive Effects of Cacao Polyphenols on the Development of Atherosclerosis in Apolipoprotein E-Deficient Mice. In: Subcellular Biochemistry, Springer 189-198. [Google Scholar] [CrossRef] [PubMed]
[19] Yusuf, S., Hawken, S., Ôunpuu, S., Dans, T., Avezum, A., Lanas, F., et al. (2004) Effect of Potentially Modifiable Risk Factors Associated with Myocardial Infarction in 52 Countries (the INTERHEART Study): Case-Control Study. The Lancet, 364, 937-952. [Google Scholar] [CrossRef] [PubMed]
[20] 袁点, 李为真, 王蓉, 等. 血清核因子-κB、肿瘤坏死因子-α、单核细胞趋化因子-1与老年冠状动脉粥样硬化性心脏病合并衰弱综合征的关系及预测模型构建[J]. 中国医刊, 2024, 59(8): 856-860.
[21] Zhang, H., Park, Y., Wu, J., Chen, X.p., Lee, S., Yang, J., et al. (2009) Role of TNF-α in Vascular Dysfunction. Clinical Science, 116, 219-230. [Google Scholar] [CrossRef] [PubMed]
[22] Zhao, Y., Shao, C., Zhou, H., Yu, L., Bao, Y., Mao, Q., et al. (2023) Salvianolic Acid B Inhibits Atherosclerosis and TNF-α-Induced Inflammation by Regulating NF-κB/NLRP3 Signaling Pathway. Phytomedicine, 119, Article 155002. [Google Scholar] [CrossRef] [PubMed]
[23] 梁天, 李飞, 刘超. 内皮细胞功能障碍与动脉粥样硬化的研究进展[J]. 中华老年心脑血管病杂志, 2024, 26(12): 1504-1507.
[24] Karbach, S., Wenzel, P., Waisman, A., Munzel, T. and Daiber, A. (2014) Enos Uncoupling in Cardiovascular Diseases—The Role of Oxidative Stress and Inflammation. Current Pharmaceutical Design, 20, 3579-3594. [Google Scholar] [CrossRef] [PubMed]
[25] 张世田, 唐汉庆, 黄岑汉, 等. 氧化应激、炎症与冠状动脉粥样硬化关系的研究进展[J]. 右江医学, 2017, 45(2): 235-239.
[26] Ellis, S.G., Kereiakes, D.J., Metzger, D.C., Caputo, R.P., Rizik, D.G., Teirstein, P.S., et al. (2015) Everolimus-Eluting Bioresorbable Scaffolds for Coronary Artery Disease. New England Journal of Medicine, 373, 1905-1915. [Google Scholar] [CrossRef] [PubMed]
[27] Niccoli, G., Montone, R.A., Lanza, G.A. and Crea, F. (2017) Angina after Percutaneous Coronary Intervention: The Need for Precision Medicine. International Journal of Cardiology, 248, 14-19. [Google Scholar] [CrossRef] [PubMed]
[28] 赵普, 李牧蔚, 沈玉祥. 经皮冠状动脉介入治疗术后血管痉挛性心绞痛的病因及诊断方法的研究进展[J]. 中国心血管病研究, 2022, 20(3): 231-235.
[29] Li, J., Zhang, Y., Yang, P., Zeng, H., Qian, X., Zhang, C., et al. (2008) Increased Peripheral Circulating Inflammatory Cells and Plasma Inflammatory Markers in Patients with Variant Angina. Coronary Artery Disease, 19, 293-297. [Google Scholar] [CrossRef] [PubMed]
[30] Hung, M., Cherng, W., Yang, N., Cheng, C. and Li, L. (2005) Relation of High-Sensitivity C-Reactive Protein Level with Coronary Vasospastic Angina Pectoris in Patients without Hemodynamically Significant Coronary Artery Disease. The American Journal of Cardiology, 96, 1484-1490. [Google Scholar] [CrossRef] [PubMed]
[31] 赵吉喆, 何祚雯, 汪道文. 炎症-血管痉挛性心绞痛的治疗新靶点[J]. 内科急危重症杂志, 2024, 30(6): 487-492.
[32] Greenland, P., Alpert, J.S., Beller, G.A., Benjamin, E.J., Budoff, M.J., Fayad, Z.A., et al. (2010) 2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults: Executive Summary. Circulation, 122, 2748-2764. [Google Scholar] [CrossRef] [PubMed]
[33] 李慧华, 吕慧, 陆建灿, 等. 糖尿病合并冠状动脉粥样硬化性心脏病患者冠状动脉病变程度与糖化血红蛋白及胆红素水平相关性分析[J]. 上海交通大学学报(医学版), 2016, 36(2): 233-236+242.
[34] Ajjan, R.A., Gamlen, T., Standeven, K.F., Mughal, S., Hess, K., Smith, K.A., et al. (2013) Diabetes Is Associated with Posttranslational Modifications in Plasminogen Resulting in Reduced Plasmin Generation and Enzyme-Specific Activity. Blood, 122, 134-142. [Google Scholar] [CrossRef] [PubMed]
[35] 张春艳, 郑阳, 郭瑄, 等. 冠心病患者糖化血红蛋白水平在冠状动脉支架术后再狭窄中的临床意义[J]. 西安交通大学学报(医学版), 2018, 39(3): 344-348.
[36] 陈辉霞. 探讨同型半胱氨酸、尿酸及糖化血红蛋白与冠状动脉粥样硬化性心脏病的相关性[D]: [硕士学位论文]. 南昌: 南昌大学, 2022.
[37] Fan, J., Liu, Y., Yin, S., Chen, N., Bai, X., Ke, Q., et al. (2019) Small Dense LDL Cholesterol Is Associated with Metabolic Syndrome Traits Independently of Obesity and Inflammation. Nutrition & Metabolism, 16, Article No. 7. [Google Scholar] [CrossRef] [PubMed]
[38] Borén, J., Chapman, M.J., Krauss, R.M., et al. (2020) Low-Density Lipoproteins Cause Atherosclerotic Cardiovascular Disease: Pathophysiological, Genetic, and Therapeutic Insights: A Consensus Statement from the European Atherosclerosis Society Consensus Panel. European Heart Journal, 41, 2313-2330.
[39] Sakai, K., Koba, S., Nakamura, Y., Yokota, Y., Tsunoda, F., Shoji, M., et al. (2018) Small Dense Low‐Density Lipoprotein Cholesterol Is a Promising Biomarker for Secondary Prevention in Older Men with Stable Coronary Artery Disease. Geriatrics & Gerontology International, 18, 965-972. [Google Scholar] [CrossRef] [PubMed]
[40] 柴晓芮, 丛洪瀛, 任明保. 小而密低密度脂蛋白胆固醇在冠心病患者中的变化及其与冠心病的关系[J]. 中华老年心脑血管病杂志, 2018, 20(6): 589-592.
[41] Banerjee, D., Perrett, C. and Banerjee, A. (2019) Troponins, Acute Coronary Syndrome and Renal Disease: From Acute Kidney Injury through End-Stage Kidney Disease. European Cardiology Review, 14, 187-190. [Google Scholar] [CrossRef] [PubMed]
[42] Heyse, A., Manhaeghe, L., Mahieu, E., Vanfraechem, C. and Van Durme, F. (2019) Sacubitril/Valsartan in Heart Failure and End-Stage Renal Insufficiency. ESC Heart Failure, 6, 1331-1333. [Google Scholar] [CrossRef] [PubMed]
[43] 高珺, 刘必成. 慢性肾病与心血管疾病共病的机制[J]. 临床荟萃, 2007(14): 1063-1065.
[44] 王金凤, 任立群, 李广生. 同型半胱氨酸对血管平滑肌细胞分泌金属蛋白酶组织抑制剂-1的影响[J]. 中国病理生理杂志, 2005, 21(3): 599-600.
[45] Al Suwaidi, J., Reddan, D.N., Williams, K., Pieper, K.S., Harrington, R.A., Califf, R.M., et al. (2002) Prognostic Implications of Abnormalities in Renal Function in Patients with Acute Coronary Syndromes. Circulation, 106, 974-980. [Google Scholar] [CrossRef] [PubMed]
[46] Seliger, S.L. (2019) Hyperkalemia in Patients with Chronic Renal Failure. Nephrology Dialysis Transplantation, 34, III12-III18. [Google Scholar] [CrossRef] [PubMed]
[47] Theilmeier, G., Michiels, C., Spaepen, E., Vreys, I., Collen, D., Vermylen, J., et al. (2002) Endothelial Von Willebrand Factor Recruits Platelets to Atherosclerosis-Prone Sites in Response to Hypercholesterolemia. Blood, 99, 4486-4493. [Google Scholar] [CrossRef] [PubMed]
[48] Gawaz, M. (2005) Platelets in Inflammation and Atherogenesis. Journal of Clinical Investigation, 115, 3378-3384. [Google Scholar] [CrossRef] [PubMed]
[49] 杨彦朝, 杨士伟, 葛海龙. 冠心病患者冠状动脉介入术前血小板体积分布宽度与预后的相关性研究[J]. 心肺血管病杂志, 2024, 43(12): 1233-1238.
[50] Ekici, B., Erkan, A.F., Alhan, A., Sayin, I., Ayli, M. and Töre, H.F. (2013) Is Mean Platelet Volume Associated with the Angiographic Severity of Coronary Artery Disease? Kardiologia Polska, 71, 832-838. [Google Scholar] [CrossRef] [PubMed]
[51] 高大顺. 血小板指标与冠心病患者PCI术后非罪犯血管病变进展的关系[D]: [硕士学位论文]. 郑州: 郑州大学, 2019.
[52] Thaulow, E., Erikssen, J., Sandvik, L., Stormorken, H. and Cohn, P.F. (1991) Blood Platelet Count and Function Are Related to Total and Cardiovascular Death in Apparently Healthy Men. Circulation, 84, 613-617. [Google Scholar] [CrossRef] [PubMed]

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