远端保护装置治疗老年急性ST段抬高型心肌梗死心肌标志物变化的研究  

Study on Cardiac Injury Markers Change in the Elderly Patients with ST Segment Elevation in Acute Myocardial Infarction Using Distal Protection Device

作　　者：要英杰[1] 邵一兵[1] 王旭[1] 王正忠[1] 

机构地区：[1]山东省青岛市市立医院东院心内科,山东青岛266071

出　　处：《现代生物医学进展》2012年第2期287-290,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨应用远端保护装置GuardWire PlusTM治疗老年急性ST段抬高型心肌梗死(STEMI)对外周血肌钙蛋白(cTnI)、肌酸激酶同工酶(CK-MB)的影响。方法:将2004年9月至2009年12月在我院行急诊PCI的60例年龄>60岁老年STEMI患者分为远端保护组(GW)和非远端保护组(NGW)。于术前、术后4h、8h、12h、16h、24h、2d、3d、5d分别测定外周血cTnI、CK-MB水平,并比较两组间变化及其峰值水平。结果:两组全部病例均成功植入支架。GW组全部成功放置GuardWire PlusTM远端保护装置。发病后12h两组CK-MB的值有明显差别(P<0.05),并且GW组出现酶峰提前,发病后6h、12h两组的CTNI的值有明显差别(P<0.05),并且GW组出现峰值提前。结论:老年心肌梗死急诊PCI中应用远端保护装置可以缩小梗死面积,改善预后。Objective： To study the changes in cTnI、CK-MB in the elderly patients with ST segment elevation in acute myocardial infarction using distal protection device（GuardWire PlusTM）.Methods： Sixty STEMI elderly patients who received percutaneous coro-nary intervention（PCI） during September 2004 to December 2009 were enrolled in the study.All the patients were divided into 2 groups which were： the distal protection device group（GW group n=30） and the non-distal protection device group（NGW group n=30）accord-ing to whether distal protection device was applied or not.The cTnI and CK-MB levels were measured on the day of operation and at 4,8,12,16 and 24 hours after the operation,as well as on 2,3,and 5 days after wards.Results： The levels of CK-MB showed a rapid de-cline in their plasma levels in the GW group compared with the NGW group on 12h after the operation（P〈0.05）.The peak level of CK-MB of GW group showed up earlier compared with the NGW group.The levels of cTnI showed a rapid decline in their plasma levels in the GW group compared with the NGW group on 6h and 12h after the operation（P〈0.05）.The peak level of cTnI of GW group showed up earlier compared with the NGW group.Conclusion： In the elderly patients with ST segment elevation in acute myocardial in-farction using distal protection device can minimize myocardial damage.

关 键 词：心肌梗死 远端保护装置 肌钙蛋白Ⅰ 肌酸激酶 MB型 

分 类 号：R542.2[医药卫生—心血管疾病]