肌酸激酶与CT冠状动脉造影下支架通畅情况的相关性  

Correlation of Creatine Kinase with Patency of Stents Using Coronary Computed Tomography Angiography

作　　者：李颖娜[1] 宋翔[1] 吴芳[1] 田树平[1] 具海月[1] 杨立[1] 

机构地区：[1]中国人民解放军总医院放射科,北京100853

出　　处：《中国医学科学院学报》2015年第2期140-146,共7页Acta Academiae Medicinae Sinicae

基　　金：国家自然科学基金(81371547)~~

摘　　要：目的探讨肌酸激酶水平与冠状动脉药物洗脱支架远期支架通畅情况的相关性。方法选取2012年1月至2014年7月在本院行药物洗脱支架置入术并进行冠状动脉计算机血管成像（CTA）复查的患者74例,支架植入时间（20.5±13.1）个月。根据冠脉CTA结果分为支架通畅组与非支架通畅组,收集同期实验室检查肌酸激酶、肌酸激酶同工酶等生化指标。计量资料的比较采用t检验或非参数检验,计数资料的比较采用卡方检验。多项Logistic回归分析各生化指标及基础和临床信息,在多种指标中只将在单变量分析时P〈0.05的指标纳入多变量Logistic回归模型确定远期支架内通畅情况的独立决定因素。结果 74例患者共置入支架74枚,冠脉CTA结果显示支架通畅患者51例、非支架通畅患者23例,支架通畅组的肌酸激酶水平和非支架通畅组分别为（75.9±29.4）U/L和（115.5±51.5）U/L,两组比较差异有统计学意义（P=0.012）;支架通畅组肌酸激酶同工酶水平高于非支架通畅组[（3.5±5.3）U/L比（1.7±1.3）U/L,P=0.034]。Logistic回归分析显示,肌酸激酶水平（OR=1.573,95%CI=1.022～2.421,P=0.039）是支架远期非支架通畅的独立决定因素。结论肌酸激酶水平是冠状动脉药物洗脱支架远期非支架通畅的独立决定因素。Objective To explore the potential correlation between creatine kinase and the long-term patency of coronary drug eluting stents. Methods The clinical data of 74 patients who had undergone coronary computed tomography angiography after drug eluting stents implantation were retrospecpectively analyzed. Based on the computed tomography angiography findings,these patients were divided into patency group and non-patency group. The mean follow-up time was（ 20. 5 ± 13. 1） months. The serum levels of creatine kinase and creatine kinase isoenzyme were measured to determine the relationship of stent patency with these oxidative-related biomarkers after long-term follow-up. The t test or non-parametric test was adopted to compare the intergroup difference of measurement data,whereas chi-square test was conducted to test the difference of enumeration data. Logistic regression was adopted to analyze the biochemical indexes and clinical information. Only variables with a P value of less than 0. 05 in the univariable analyses entered the multivariate Logistic regression model. Results Patientsin the non-patency group had significantly higher serum creatine kinase level compared with patients in patency group [（ 115. 5 ± 51. 5） U / L vs.（ 75. 9 ± 29. 4） U / L,P = 0. 012] and significantly higher level of creatine kinase isoenzyme [（ 3. 5 ± 5. 3） U / L vs.（ 1. 7 ± 1. 3） U / L,P = 0. 034]. Furthermore,the Logistic analysis showed that serum creatine kinase level（ odds ratio = 1. 573,95% CI = 1. 022- 2. 421,P = 0. 039） was an independent predictor of stent patency. Conclusion Creatine kinase is an independent risk factor associated with stent non-patency.

关 键 词：肌酸激酶 药物洗脱支架 支架通畅 非支架通畅 预测作用 

分 类 号：R816.2[医药卫生—放射医学]