尿微量白蛋白在冠状动脉介入治疗术后对心肌损伤的评估作用  

The Value of Preoperative Microalbuminuria Level for Predicting Myocardial Injury After Selective Coronary Intervention

作　　者：王红梅[1] 胡耀华[1] 章若涵[1] 田黎明[1] 何军[1] 胡艳群[1] 

机构地区：[1]南华大学附属南华医院,湖南省衡阳市421001

出　　处：《中国动脉硬化杂志》2010年第12期982-984,共3页Chinese Journal of Arteriosclerosis

摘　　要：目的探讨冠状动脉介入治疗术后尿微量白蛋白的变化及其对心肌损伤的评估作用。方法经皮冠状动脉介入治疗患者86例,手术方式全部为经皮腔内血管成形术及支架术。于手术前即刻及术后24 h,分别采集肘静脉血3 mL,采用电化学发光测定心肌型肌酸激酶同工酶、心肌肌钙蛋白I和肌红蛋白水平,分析与比较微量白蛋白尿阳性组和微量白蛋白尿阴性组上述心肌损伤标志物水平的变化。结果微量白蛋白尿阳性组术后心肌肌钙蛋白I、心肌型肌酸激酶同工酶水平分别为1.68±0.74μg/L、10.16±4.18μg/L,明显高于术前微量白蛋白尿阳性组和术后微量白蛋白尿阴性组(P<0.05);微量白蛋白尿阳性组术后肌红蛋白水平为40.16±15.82μg/L,明显高于术前的16.68±6.45μg/L(P<0.05),但与术后微量白蛋白尿阴性组比较差异无显著性(32.35±11.38μg/L;P>0.05)。结论两组患者术后心肌肌钙蛋白I、心肌型肌酸激酶同工酶和肌红蛋白水平与术前相比升高,提示冠状动脉介入治疗可引起心肌损伤。微量白蛋白尿阳性组术后心肌肌钙蛋白I和心肌型肌酸激酶同工酶水平高于微量白蛋白尿阴性组,提示术前微量白蛋白尿阳性对冠状动脉介入治疗术后心肌损伤具有一定的预测价值。Aim To investigate the changes of microalbuminuria and to assess the role of myocardial injury after percutaneous coronary intervention（PCI）. Methods 86 patients who underwent PCI were enrolled.Blood samples were respectively collected immediately before and after PCI at 24 hours,myocardial creatine kinase-MB（CK-MB）,cardiac troponin I（cTnI） and myoglobin（MB） were detected by Electrochemiluminescence,then the changes of myocardial injury markers were analyzed and compared between MAU-positive group and negative group. Results After 24 hours of operating,cTnI and CK-MB levels of MAU-positive group were 1.68±0.74 μg/L and 10.16±4.18 μg/L respectively.cTnI and CK-MB levels of MAU-positive group were significantly higher than MAU-negative group（P0.05）.MB levels of MAU-positive group after 24 hours of operating were higher than preoperating（40.16±15.82 μg/L vs 16.68±6.45 μg/L）,but there were no signifiant differences between MAU-positive group and MAU-negative group after 24 hours of operating. Conclusion Postoperative cTnI,CK-MB and MB levels in the two groups were higher than preoperative levels,the differences had statistical significance,it suggested that PCI caused myocardial injury;postoperative cTnI and CK-MB levels of MAU-positive group were significantly higher than MAU-negative group.Preoperative MAU being positive had significantly predicted effect on myocardial injury after coronary intervention.

关 键 词：尿微量白蛋白 经皮冠状动脉介入治疗 心肌损伤 

分 类 号：R5[医药卫生—内科学]