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目的：通过对冠心病患者经皮冠状动脉介入治疗(PCI)前后血清Caspase-3,9 水平变化的观察，探讨冠状动脉介入治疗对冠心病患者血清Caspase-3,9 水平的影响。方法：冠状动脉介入组（PCI 组）30 例和单纯造影组（CAG 组）29 例，在术前0.5h，术后 3h，术后6h，术后12h，术后24h，术后48h 分别测定血清Caspase-3,9 水平。结果：CAG 组术前与术后的血清Caspase-3,9 水平差异均无统计学意义，PCI 组术后3h、6h 的Caspase-3 水平较术前0.5h 均有降低趋势，差异均有统计学意义（P<0.05），PCI 组术后 48h 的Caspase-9 水平与术后3h、6h 相比均有升高趋势，差异均有统计学意义（P<0.05）。结论：PCI 术后狭窄或闭塞的冠状动脉血管重新恢复血供，血清中Caspase-3,9 水平在PCI 术后先降低后又逐渐升高，提示再灌注后可出现细胞的凋亡程度加重，血清中 Caspase-3,9 的水平可作为心肌再灌注损伤后细胞凋亡程度的评估指标并可作为诊断临床症状不典型的再灌注损伤的一个指标。 PCI 术可有效改善心肌血供，减少因术前缺血缺氧造成的细胞凋亡，但PCI 术后再灌注损伤可进一步加重细胞凋亡。

英文摘要:

Objective: To observe influence of percutaneous coronary intervention (PCI) on Caspase-3,9 levels of the coronary heart disease. Methods: Thirty patients who underwent PCI, and thirty patients who underwent coronary angiography (CAG) were enrolled in this study. Serum Caspase-3,9 levels before 0.5h and 3h, 6h, 12h, 24h, 48h after PCI were assayed in all patients. Results: There were no significant differences in serum Caspase-3,9 levels between before and after CAG. Caspase-3 levels at 3h, 6h after PCI were lower than before 0.5h. Statistical differences were observed between them. After PCI, Caspase-9 level at 48h was higher than at 3h, 6h. The differences between them were statistical significance. Conclusion: Stenotic or obstructive coronary arteries were recanalization after PCI. Caspase-3,9 levels in serum decreased earlier after PCI, then they increased gradually. These means reperfusion aggravated apoptosis after PCI. Serum Caspase-3,9 may be a marker of evaluate apoptosis degree in myocardial reperfusion injury and diagnose untypical reperfusion injury in clinic. Blood supply of aeteria coronaria would be improved after PCI. Apoptosis of myocardial and hypoxia was decreased as well. But apoptosis might become graved because of reperfusion injury.

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