冠心病经皮冠状动脉介入治疗后肌酸激酶及其同工酶增高的因素  

Analysis of factors inducing creatine kinase elevations after percutaneous coronary interventions

作　　者：郭来敬[1] 唐强[1] 史震涛[1] 王智[1] 张树和[1] 何山[1] 艾永珍[1] 刘月光[1] 陈学珠[1] 

机构地区：[1]北京大学首钢医院心内科,100041

出　　处：《中国介入心脏病学杂志》2005年第5期307-308,共2页Chinese Journal of Interventional Cardiology

摘　　要：目的探讨冠心病经皮冠状动脉介入治疗(PCI)后肌酸激酶(CK)及其同工酶(CKMB)增高的因素。方法对112例PCI术后4～20h(平均11.52±4.86h)的患者常规检测CK和CKMB。如果测定值在正常范围者,则不再检测,如超过正常范围则次日连续检测,直至正常。以CK值≥正常上限的2倍为增高组(n=12),在正常范围为正常组(n=89),介于两者之间者(n=11)为轻度增高组。结果组间平均年龄、血压、糖尿病、心绞痛分级、吸烟史和左心室射血分数(LVEF)比较差异均无统计学意义。组间>20min的胸痛、冠状动脉分支闭塞、冠状动脉内膜撕裂比较,差异有统计学意义。两组间病变复杂程度在增高组较为明显,而正常组病变较轻,但差异无统计学意义。结论PCI术后部分患者CK、CKMB增高与术中复杂病变、冠状动脉撕裂、分支闭塞、微血栓及微栓塞形成等因素有关。Objective To investigate the factors inducing creatine kinase elevation after pereutaneous coronary Interventions （PCI）. Methods The creatine kinase （CK） and CK-MB levels were detected in 112 patients 4 to 20 hours after PCI. The patients were divided into three groups according to the peak CK and CK-MB isoenzyme after the procedure. The significant elevation group （n=12） had a peak CK level above 390 u/L. The normal group （n=89） had no CK or CK-MB elevation, and the minor elevation group had a peak CK level between 196 and 390 u/L. Results There were no differences in the mean age, presence of hypertension, diabetes, CCS classification of angina pectoris, smoking and left ventricular ejection fraction （LVEF） among the 3 groups. However, there were significant differences in prolonged chest pain （ 〉 20 minutes ）, side branch occlusion, coronary dissection among the 3 groups. There were no differences in the complex or multivessels lesions either. Conclusion Significant elevation of CK and CK-MB after PCI may be associated with multivessels intervention, coronary dissection, side branch occlusion and micro-thrombus formation.

关 键 词：冠心病 血管成形术 经腔 经皮冠状动脉 肌酸激酶 经皮冠状动脉介入治疗 肌酸激酶(CK) 同工酶 冠心病 介入治疗后 增高 左心室射血分数 正常范围 动脉内膜撕裂 

分 类 号：R654.2[医药卫生—外科学] R459.6[医药卫生—临床医学]