PTCA支架术后血清肌钙蛋白I的变化及其相关因素  

Changes in the level of serum cTnI after PTCA and stent placement

作　　者：袁文照 吕安林[1] 李春梅[1] 赵月胜 郭宁[3] 李家一[1] 周宁[1] 周景昱[1] 赵国华 

机构地区：[1]第四军医大学西京医院心内科 [2]山西省夏县中医院内科,044400 [3]陕西省渭南市二院,714000 [4]陕西省府谷县医院急诊科,719400

出　　处：《心脏杂志》2002年第6期499-500,503,共3页Chinese Heart Journal

摘　　要：目的 :观察经皮腔内冠状动脉成形术 (PTCA)和支架术后血清肌钙蛋白 I(c Tn I)和磷酸肌酸激酶 (CK)的变化并分析相关因素。方法 :分别测定不同临床类型冠心病患者 85例 PTCA支架术前及术后 2 4 h的 c Tn I和 CK水平 ,并分组比较。结果 :稳定型心绞痛 16例 ,不稳定型心绞痛 4 1例 ,陈旧性心肌梗死 2 8例 PTCA支架术后 ,c Tn I水平均较术前升高 (P<0 .0 1) ;而 CK手术前后无明显变化 (P>0 .0 5 )。 c Tn I升高组的扩张时间、扩张压、扩张次数、支架术、手术血管严重狭窄 (≥ 95 % )的比例高于未升高组 (P<0 .0 1) ;不稳定型心绞痛组与陈旧性心肌梗死组术后c Tn I升高的比例高于稳定型心绞痛组 (P<0 .0 1)。结论 :PTCA支架术可造成心肌的轻度损伤。c Tn I升高可能与扩张的时间、压力、次数、置入支架数量、原来血管狭窄程度。AIM: To investigate the effects of percutaneous transluminal coronary angioplasty(PTCA) and stent placement on myocardium, through observing changes in the level of cTnI and CK. METHODS: 85 patients with coronary heart disease received PTCA and stent placement. We collected blood samples of the patients before PTCA and 24 hours after the operation. Levels of cardiac triponin I(cTnI) and Creatine Kinase(CK) were determined. RESULTS: Among the patients, there were 16 with stable angina pectoris, 41 with unstable angina pectoris,and 28 with old myocardial infarction. Levels of cTnI in all groups after the operation were significantly higher than those before PTCA( P <0.01), while the level of CK didn't change(remained normal)( P >0.05).The duration of total inflations,peak inflation pressure,number of inflations,number of stents implanted and stenosis degree were significantly great in the group of the cTnI level increased than in the group of the cTnI level not increased( P <0.01). The percentage increase of the cTnI level was less in the stable angina pectoris group than in the unstable angina pectoris group and in the old myocardial infaction group( P <0.01). CONCLUSION: PTCA and stent placement could cause slight injuries on myocardium. The increase of cTnI might have something to do with the duration of stretch, pressure, times, the numbers of stents, the original narrow level of vessel and clinical types.

关 键 词：血管成形术 经皮冠状动脉 支架术 肌钙蛋白 

分 类 号：R543.31[医药卫生—心血管疾病]