摘要
目的 通过动态测定行经皮冠状动脉腔内成形术 (PTCA)患者的血清肌钙蛋白Ⅰ (cTnI)及肌酸激酶同功酶CK MB的变化 ,并随访观察心脏事件的发生率 ,以评价cTnI对预后的判断价值。方法 对 73例行PTCA术的冠心病患者 ,分别测定其术前 ,术后 6 ,12 ,2 4,48,72h的血清cTnI及CK MB水平 ,进行分组比较 ,其中 6 2例患者进行随访观察。结果 2 0例患者术前cTnI正常 ,术后 6h升高 ,平均 (18± 6 )h达峰值 ,48～ 72h渐降至正常 ;33例术前和术后cTnI均正常 ;16例术前术后cTnI均高于正常值。仅 5例CK MB增高。cTnI升高与PTCA总时间及扩张次数有关。随访 (196± 10 0 )d ,发现心脏事件在cTnI增高组与未升高组之间差异无显著性 (P >0 0 5 )。结论 PTCA术可能会造成心肌微小损伤 ,cTnI为监测心肌损伤的可靠而灵敏指标。PTCA术后cTnI短暂升高似乎并不增加心脏事件的发生率。
Serum cardiac troponin Ⅰ (cTnI) and creatine kinase MB (CK-MB) levels were monitored before and after percutaneous transluminal coronary angioplasty (PTCA), to evaluate prognostic value of cTnI level in patients with PTCA Methods Serum cTnI and CK-MB were measured in 73 patients with coronary artery disease (CAD) undergoing PTCA Before and 6, 12, 24, 48, 72 hours after the procedure respectively, and follow-up observation was done Results The serum cTnI levels of 20 cases began to increase at 6 hours (9 65±4 74 μg/L), reached the peak levels during 18±6 hours (21 43±9 58 μg/L) and returned to normal levels during 48～72 hours (5 51±3 13 μg/L) after PTCA Ones of 33 cases remained normal range, but ones of 16 cases were over baseline levels before and after the procedure, while CK-MB levels of 5 cases were over normal range in those patients Compared with normal cTnI group, elevated cTnI was related to total inflation time and dilatation times ( P <0 05) Over a follow-up of 196±100 days, 8% of the patients experienced adverse events, and cTnI did not identify a population of worse long-term prognosis Conclusion PTCA may cause some minor damage of myocardium, cTnI serum levels was more sensitive and specific for monitoring myocardial injury, but these elevated concentrations of cTnI in the short-term aftermath of angioplasty do not seem to be a marker of worse long-term prognosis
出处
《中国介入心脏病学杂志》
2000年第3期124-126,共3页
Chinese Journal of Interventional Cardiology
