冠状动脉支架置入术后肌钙蛋白Ⅰ变化的临床意义  

Clinical value of Change of troponin Ⅰ following coronary stenting

作　　者：叶红华[1] 潘伟民[1] 陈晓敏[1] 杜为平[1] 储慧民[1] 

机构地区：[1]宁波市第一医院心内科,浙江宁波315010

出　　处：《临床心血管病杂志》2004年第12期725-727,共3页Journal of Clinical Cardiology

摘　　要：目的 :探讨冠状动脉 (冠脉 )支架置入术后肌钙蛋白Ⅰ的变化、预后意义和相关因素。方法 :76例行择期冠脉支架置入术且术前肌钙蛋白Ⅰ正常的患者 ,监测术前 ,术后 12、2 4h肌钙蛋白Ⅰ ,观察 6～ 12个月内主要心血管事件。结果 :76例中出现术后肌钙蛋白Ⅰ升高 2 8例 (36 .84 % )。在 6～ 12个月随访中术后肌钙蛋白Ⅰ升高组和正常组主要心血管事件发生差异无统计学意义 ,但升高组住院期间再发心肌缺血高于正常组 (10 / 2 7∶7/4 4 ,P <0 .0 5 )。且均为肌钙蛋白Ⅰ峰值大于该组平均峰值者。多元逻辑回归分析示球囊扩张总时间和不稳定型心绞痛与肌钙蛋白Ⅰ升高有关。结论 :择期冠脉支架置术后肌钙蛋白Ⅰ可升高。术后肌钙蛋白Ⅰ升高者近期再发心肌缺血增加。术后肌钙蛋白Ⅰ升高和中期随访时心脏事件发生未见明显关系 。Objective: To investigate clinical value of change of troponinⅠ following coronary stenting.Method: Troponin Ⅰ was monitored before and 12, 24 h after procedure in 76 patients who underwent selective coronary stent implantation with normal troponin Ⅰ before procedure. Major cardiovascular events (death, myocardial infarction, revascularization of target vessel and recurrent myocardial ischemia)were recorded in 6～12 months of follow-up. Result:After procedure, troponin Ⅰ increased in 36.84% of patients above, major cardiovascular events occurred without significant difference between group with increased troponin Ⅰ and normal one, except in hospital recurrent myocardial ischemia, which occurs more often in group with increased troponin Ⅰ (10/27 vs 7/44, P< 0.05). Total inflation time and unstable angina were associated with troponin Ⅰ increase. Conclusion:Troponin Ⅰ may increase following coronary stenting. There are more recurrent myocardial ischemia in hospital with troponin Ⅰ increasing following procedure. But troponin Ⅰ increase after procedure dosen't affect major cardiovascular events in 6～12 months follow-up. Total inflation time and unstable angina were associated with troponin I increase.

关 键 词：冠状动脉疾病 支架 肌钙蛋白I 

分 类 号：R814.47[医药卫生—影像医学与核医学]