冠状动脉介入治疗后心肌钙蛋白T的动态变化及原因分析  

Changes and clinical value of serum cardiac troponin T levels after percutaneous coronary interventions

作　　者：周双陆 成功 颜昌福 陈均良 杜志林 夏福纯 李暾 贺健 邓盛荣 

机构地区：[1]攀枝花钢铁公司职工总医院,四川攀枝花市617023

出　　处：《心血管康复医学杂志》2005年第6期531-533,共3页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:了解成功行经皮冠状动脉介入治疗(PCI)病人的心肌肌钙蛋白T(cTnT)水平的动态改变及临床意义。 方法:选择成功行PCI术的68例患者,在术前、术后6 h、24 h分别检测肌酸激酶(CK)、肌酸激酶同功酶(CK- MB)及cTnT水平,并分析相关因素。结果:PCI术后CK-MB升高7例(10．3％)。cTnT术后升高32例(47．1％), C型病变:在cTnT升高组中17例(53．1％),与cTnT正常组10例(27．8％)比较有显著差异(P=0．033 0)。三 支血管病变:cTnT升高组中13例(40．6％),与cTnT正常组5例(13．9％)比较有显著差异(P=0．012 6)。cTnT 升高的原因和扩张压力总和、扩张次数及扩张时间有关(P=0．007 2．P=0．000 2,P=0．021 3),支架长度和支架 直径也和cTnT水平有关(P=0．015 6,P=0．001 2)。结论:PCI术后可引起CK-MB、cTnT水平轻度升高,在检 测心肌损伤方面cTnT较CK、CK-MB更敏感。病变的复杂程度及手术操作的强度与cTnT水平升高有关。Objective： To evaluate the changes and clinical value of serum cardiac troponin T （eTnT） in patients with successful percutaneous coronary intervention （PCI）. Methods： The 68 patients after successful PCI were chosen. Serum cTnT and creatine kinase （CK）, CK-MB were measured before and at 6h, 24h after the procedure respectively, and the relative factors in PCI were analyzed. Results： The 7 cases （10.3%） had elevated CK-MB activity after PCI, while cTnT level increased after the procedure was in 32 cases （47.10%）. The elevated cTnT was related to type C lesions （P〈0. 05）. Triple vessel lesions in elevated cTnT group were more significant than that of normal cTnT group （P〈0.05）. The higher level of cTnT after PCI may be associated with the higher total inflation pressure and times of inflation as well as total dilated time （P=0. 007 2, P=0. 021 3, P=0. 000 2）, stent length and diameter （P=0. 015 6, P=0. 001 2）. Conclusion： Elevated cTnT level may be related to intensity of PCI and complex of vessel lesion and is more sensitive in detecting minor myocardial injury after PCI.

关 键 词：血管成形术 经腔 经皮冠状动脉 肌钙蛋白T 肌酸激酶 

分 类 号：R541.4[医药卫生—心血管疾病]