目的探讨前列腺素E1注射液联合通心络胶囊对经皮冠状动脉介入治疗(PCI)术后再狭窄及外周血单核细胞NF-κB及白细胞介素-6(IL-6)活性的影响。方法选择冠状动脉造影证实,并行PCI术冠心病患者220例,随机分为常规治疗组(对照组,n=73)、加用前列腺素E1注射液组(西药组,n=70)、加用前列腺素E1注射液及通心络胶囊组(中西药组,n=77)。比较3组患者PCI术前及术后7 d及28 d NF-κB、IL-6水平及半年内再次行冠脉造影血管再狭窄病变情况。结果中西药组干预后NF-κB及IL-6水平明显低于对照组及西药组(P<0.01),半年内血管支架内再狭窄发生率及狭窄程度均低于对照组及西药组(P<0.01)。结论前列腺素E1注射液联合通心络胶囊可显著抑制PCI术后炎症因子的表达,并减轻血管再狭窄程度。
Pickering综合征表现为反复的肺水肿和肾功能损害,与肾动脉狭窄有关。本病例描述了一位82岁女性患者,有高血压和冠心病史,伴有肾血管狭窄,反复出现肺水肿。影像学显示肾血管狭窄从单侧发展到双侧。尽管接受药物治疗,患者仍反复肺水肿。肾血管介入治疗后,患者病情稳定,心脏和肾脏功能改善。此病例强调识别肾动脉狭窄的重要性,并显示及时诊断和治疗的益处。早期识别和治疗Pickering综合征可有效预防肺水肿和肾功能衰竭。Pickering syndrome is characterized by recurrent pulmonary edema and renal impairment associated with renal artery stenosis. This case describes an 82-year-old woman with a history of hypertension and coronary artery disease, renal vascular stenosis, and recurrent pulmonary edema. Imaging shows renal vascular stenosis progressing from unilateral to bilateral. Patients have recurrent pulmonary edema despite medication. After renal vascular intervention, the patient’s condition was stable and his heart and kidney function improved. This case highlights the importance of identifying renal artery stenosis and shows the benefits of prompt diagnosis and treatment. Early recognition and treatment of Pickering syndrome is effective in preventing pulmonary edema and renal failure.
