冠脉介入治疗前后心肌损伤因子变化及原因探讨  

The changes of cardiac muscle injury factor before and after coronary intervention therapy and discussion of the reasons.

作　　者：管耘园[1] 王毅[1] 盛臻强[1] 黄建飞[1] 施海峰[1] 林刚[1] 张莉[1] 金恒[1] 王世襄[1] 华守明[1] 

机构地区：[1]南通医学院第二附属医院心内科,江苏226001

出　　处：《中国综合临床》2003年第1期20-21,共2页Clinical Medicine of China

摘　　要：目的评价冠脉介入治疗术 (PCI)在恢复正常冠脉血流的同时 ,分析可能造成心肌缺血及微小损伤的原因及结果。方法 46例接受PCI治疗的患者在术前、术后不同时间抽取肘静脉血检测CK MB、cTnT、CRP ,同时对手术中球囊加压时间、次数、平均压力等因素进行分析。结果术后cTnT升高占 63 .0 4% (2 9/ 46)、CRP升高占 5 0 .0 0 % (2 3 / 46) ,与术前相比有显著性差异 (P <0 .0 1) ,其高峰出现在 2 4小时 ,有非常显著性差异 (P <0 .0 0 1) ,CK MB术前术后差异无统计学意义 (P >0 .0 5 )。cTnT和CRP升高与球囊扩张时间、次数及平均压力密切相关 (P <0 .0 5 )。结论尽管PCI可能造成患者心肌缺血及微小损伤 ,但这一过程是短暂和可逆的 。Objective To evaluate the reasons and results of myocardial ischemia and minor injury when percutaneous coronary intervention(PCI) recovering the normal coronary artery blood flow,through the analysis of the changes of cardiac muscle injury factor and related factors.Methods CK MB,cTnT,and CRP from elbow vein blood of 46 cases receiving PCI were detected before operation,at 6 h,24 h,48～72 h after operation and then were analyzed statistically.At the same time,the press time,times,and average pressure of balloon were analyzed.Results After operation,cTnT and CRP were increased in 63.04% (29/46) and 50.00%(23/46) patients,respectively,which were significantly different from that before operation(P<0.01).They peaked at 24h,with remarkable difference (P<0.001) .There was no statistic significance in CK MB before and after operation(P>0.05).The increase of cTnT and CRP were closely related with the dilation time,times and average pressure of balloon (P<0.05) .Conclusion Although PCI may result in myocardial ischemia and minor injury to some patients,it is reversible and short.Therefore,PCI is the most effective and safe therapy to those patients with bad therapeutic effect of medicines.

关 键 词：冠脉介入治疗 心肌损伤因子 原因 冠心病 临床研究 

分 类 号：R541.4[医药卫生—心血管疾病] R815[医药卫生—内科学]