完全血运重建对冠心病患者经皮冠状动脉介入治疗术后近期和远期预后的影响  

Influence of complete revascularization on short-term and long-term prognosis of patients with coronary heart disease after percutaneous coronary intervention

作　　者：王益民[1] 马琦[1] 梁冰 卫政[1] 盖盛坤 邓俊萍 Wang Yimin;Ma Qi;Liang Bing;Wei Zheng;Gai Shengkun;Deng Junping(Department of Cardiology, Linfen Hospital Affiliated to Shanxi Medical University, the Seventh Clinical Medical College, Linfen People’s Hospital, Linfen 041000, China)

机构地区：[1]山西医科大学附属临汾医院(第七临床医学院)临汾市人民医院心血管内科,041000

出　　处：《中国实用医刊》2019年第11期75-79,共5页Chinese Journal of Practical Medicine

摘　　要：目的 探讨完全血运重建对冠心病患者经皮冠状动脉介入治疗(PCI)术后近期和远期预后的影响.方法 回顾性分析2016年7月至2017年7月在山西医科大学附属临汾医院行PCI的74例冠心病患者的临床资料,根据完全血运重建与否将其分为完全血运重建组41例与不完全血运重建组33例.记录并比较两组患者PCI术前及术后24 h肌酸激酶同工酶( CK-MB)、肌钙蛋白Ⅰ(cTnI)、超敏C反应蛋白( hs-CRP)以及缺血修饰白蛋白(IMA)水平以及术后30 d、术后1 年主要不良心血管事件( MACE).结果 PCI 术前两组患者 CK-MB、cTnI、hs-CRP、IMA水平比较差异未见统计学意义(P>0.05);PCI术后24 h两组患者CK-MB、cTnI、hs-CRP水平均升高,但完全血运重建组患者CK-MB [(23.81 ±2.64) IU/L]、cTnI [(0.06 ±0.03)μg/L]、hs-CRP [(6.84 ±0.91)mg/L]均低于不完全血运重建组[(27.19 ±3.12) IU/L、(0.09 ±0.04) μg/L、(9.52 ±1.27) mg/L],差异有统计学意义( P<0.05);而PCI术后24 h两组患者IMA水平均略微降低,两组间比较差异未见统计学意义(P>0.05).完全血运重建组患者术后30 d MACE发生率为4.88%(2/41),术后1年MACE发生率为9.76%(4/41),均分别低于不完全血运重建组的15.15%(5/33)、33.33%(11/33),差异均有统计学意义( χ2 =5.769、6.103, P 均 <0.05).结论 完全血运重建可减轻PCI术中心肌损害,且完全血运重建冠心病患者PCI术后近期和远期预后较好.Objective To investigate the influence of complete revascularization on short-term and long-term prognosis of patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods Retrospective analysis was performed on the clinical data of 74 patients with coronary heart disease undergoing PCI in Linfen Hospital Affiliated to Shanxi Medical University from July 2016 to July 2017.And the 74 patients were divided into the complete revascularization group (41 cases) and the incomplete revascularization group (33 cases) according to undergoing complete revascularization or not . The creatine kinase MB ( CK-MB ), cardiac troponinⅠ( cTnI ), high sensitive C reactive protein (hs-CRP) and ischemia modified albumin ( IMA) levels of the two groups before and 24 hours after PCI were recorded and analyzed .And the major adverse cardiovascular events (MACE) 30 days and 1 year after PCI of the two groups were compared .Results There was no statistically significant in CK-MB, cTnI, hs-CRP, IMA levels between the two groups before PCI ( P>0.05) .The CK-MB, cTnI, and hs-CRP levels were significantly increased in both groups 24 hours after PCI.The CK-MB, cTnI and hs-CRP 24 hours after PCI of complete revascularization group were (23.81 ±2.64) IU/L, (0.06 ± 0.03) μg/L and (6.84 ±0.91) mg/L, respectively, which were significantly lower than the (27.19 ± 3.12) IU/L, ( 0.09 ±0.04 ) μg/L, ( 9.52 ±1.27 ) mg/L of incomplete revascularization group ( P<0.05).However, the IMA levels of the two groups decreased slightly 24 hours after PCI, but there was no statistically significant between the two groups (P>0.05).The incidence of MACE in complete revascularization group 30 days and 1 year after operation were 4.88%(2/41 ) and 9.76%( 4/41 ), respectively, which were significantly lower than the 15.15%( 5/33 ) and 33.33%( 11/33 ) of incomplete revascularization group ( χ2 =5.769, 6.103, all P <0.05 ).Conclusions Complete revascularization can alleviate myocardia damage during PCI , and coronary heart disease

关 键 词：完全血运重建 冠心病 经皮冠状动脉介入治疗 预后 

分 类 号：R541.4[医药卫生—心血管疾病]