冠状动脉腔内成形术术后cTnI增高的发生率、原因及短期预后研究  

Study of Incidence.Associated Causes and Short-term Prognosis of Troponin I Elevation after Percutaneous Coronary Intervention

作　　者：伍旭升[1] 许澎[1] 张高峰[1] 朱淑贤[1] 乔祺[1] 俞利群[1] 

机构地区：[1]复旦大学附属上海市第五人民医院心内科,上海200240

出　　处：《中国临床医学》2007年第6期760-763,共4页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨冠状动脉腔内成形术(PCI)术后肌钙蛋白增高的发生率、原因及其对短期预后的预测价值。方法:选择2004年4月-2007年4月住院患者216例,其中冠脉造影(CAG)112例,男性71例,女性25例,平均年龄(49.2±5.6)岁(32～74岁);PCI术104例、男性79例、女性25例,平均年龄(62.4±9.7)岁(36～82岁),分别检测其术前、术后0h、4h、8h、16h、24 h、48h时血清cTnI、CK-MB、CRP水平,统计其术后cTnI增高的发生率.分析其产生原因,随访观察是否发生严重心脏事件。结果:单纯CAG患者造影前后血浆cTnI、CK-MB、CRP无显著变化(P>0.05),造影后cTnI升高的发生率为2.7%。PCI术后4h cTnI开始升高(P<0.05),24h达高峰,48h降至正常水平,cTnI升高的发生率为38.5%,同时伴CRP升高(P<0.05),而CK-MB升高不明显。结论:单纯做冠脉造影(CAG)cTnI、CK-MB及CRP无变化。PCI术后cTnI升高的发生率不低,但其峰值不高,且持续时间不长,术后cTnI短期升高并不影响其近期预后。Objective：To investigate the incidence and short-term prognostic value of cardiac troponin I（cTnI） elevation after percutaneous coronary intervention （PCI） and evaluate the associated causess for cTnI elevation. Methods： 216 in-hospital patients were selected between 2004.4-2007.4,112 patients [72 male ,40 female , age（49.2±5.6）years,ranging between 32-74years] undergoing coronary angiography （CAG） and 104 patients [79 male,25 female , age（62.4±9.7）years,ranging between 36-82years] undergoing percutaneous coronary intervention （PCI） were evaluated with serum CK-MB and C-reactive protein（CRP） and cTnI before,immediately,4 h,8 h, 16 h,24 h,and 48 h after the procedures. Major Cardiac Events in these patients were also followed-up. Results：There is no significant difference in CAG group with regard to cTnI,CK-MB and CRP, the incidence of cTnI increase in CAG group was 2.7% ,while in PCI group ,as compared basic value , cTnI and CRP elevated significantly 4h after procedure（P〈0.05）, and reached peak value 24h after procedure and recovered to basic value 48h after PCI, however CK-MB didn＇t demonstrate the similar change （P〉0.05） and the incidence of plasma cTnI increase was 38.5%. Conclusion：There was no significant change with respect to cTnI, CK-MB and CRP in CAG group, while the incidence of cTnI elevation appeared relatively high in PCI group, but the peak concentration was relatively low and lasted a short time, transient cTnI elevation after PCI had no marked effect on short-time prognosis.

关 键 词：肌钙蛋白I 肌酸肌酶MB同工酶 C反应蛋白 冠状动脉造影术 冠状动脉腔内成形术 冠心病 

分 类 号：R654.3[医药卫生—外科学]