急性冠脉综合征患者PCI术后cTnI的变化及其对心脏不良事件的预测价值  

Research on the changes which comes after PCI cTnI and its predictive value of MACE in ACS patients

作　　者：赵强[1] 肖强[1] 李元民[1] 郭军凤[1] 康玲[1] 李秀昌[1] 

机构地区：[1]泰山医学院附属医院心血管内科,山东泰安271000

出　　处：《中国医学装备》2014年第2期25-28,共4页China Medical Equipment

基　　金：山东省医药卫生科技发展计划(009HZ097)"节段应变率及节段射血分数对冠脉内支架植入术前后左室局部功能的评价及其PCI疗效预测价值"

摘　　要：目的:探讨入院时肌钙蛋白-I(cTnI)阴性的急性冠脉综合征(ACS)患者在择期行经皮冠状动脉介入治疗(PCI)后血浆cTnI水平变化及其与冠脉病变、介入操作及预后的关系。方法:选取择期行PCI的ACS患者106例,术前和术后24 h测定血浆cTnI水平,记录手术操作中的各项指标,随访主要心脏不良事件(MACE)的发生情况。结果:不稳定型心绞痛(UAP)、糖尿病、分叉病变、多支病变、支架长度、球囊扩张总时间和总次数在cTnI升高组及正常组之间差异有统计学意义。将上述指标列入多元回归模型,分析显示球囊扩张总时间、UAP及糖尿病在两组间差异有统计学意义。cTnI升高组MACE发生较多。结论:①UAP、糖尿病、分叉病变、多支病变和球囊扩张总时间、总次数及支架长度等因素与PCI相关心肌损伤有关;②cTnI对ACS患者行PCI术后早中期发生MACE具有较好的预测价值。Objective：To discusses the changes of plasma cTnI levels and its relationship with coronary artery disease, interventional operation, the prognosis in acute coronary syndrome patients with cTnI-negative in elective percutaneous coronary intervention after treatment. Methods：We select clinical data about 106 cases of elective PCI treatment of patients, determine plasma cTnI levels in preoperative and postoperative 24 hours, record the index about operative and follow up major adverse cardiac events occurrence. Results：Unstable angina pectoris, diabetes mellitus, bifurcation lesions, multivessel disease, stent length , the total number and total time of balloon dilatation have statistically significance between the elevated group and the normal group of cTnI. With the seven indicators included in the multiple regression models shows that the total time of balloon angioplasty, unstable angina, diabetes difference between the two groups has statistical significance. After PCI, cTnI elevated group of patients with MACE occurred are more. Conclusion： 1.The factors of UAP, DM, bifurcation lesions, multivessel disease, balloon total time and total number of stent length are associated with PCI myocardial injury related;2. The detection of cTnI has predictive value of MACE in ACS patients early and mid-term.

关 键 词：急性冠状动脉综合征 经皮冠状动脉介入治疗 心脏不良事件 

分 类 号：R543.3[医药卫生—心血管疾病]