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1.
To compare the outcomes of an invasive with a conservative strategy in the management of patients with non-ST-elevation acute coronary syndromes. Methods From January 2000 to June 2001,505 patients presenting with unstable angina or non-Q wave myocardial infarction were divided into two groups (conservative vs. invasive) according to management strategy. Patients assigned to an early invasive strategy underwent coronary angiography within 7d of enrollment after intensive antiplatelet, antithrombotic and antiangina therapy and revascularization as appropriate. All patients were followed up at least 6 months. The primary endpoints were cardiac death and acute myocardial infarction. Recurrence angina and readmission were the secondary endpoint. Results There were 194 patients in conservative group and 311 patients in invasive group. Overall, coronary angiography was performed in 100% and 56%, and revascularization in 93% and 52% in the invasive and conservative groups, respectively. During a mean of 11 5. 7 months ( range 6 ~ 24 months) of follow-up, the occurrence of primary endpoint was significantly lower in the invasive group than that in the conservative group (3.9% vs8. 2% , P =0. 036). The rate of recurrent angina (48% vs 17% , P =0. 001 ) , readmission (41% vs 13% , P =0. 001 )and revascularization ( 12% vs 35%, P =0. 001 ) was also significantly lower in patients assigned to invasive strategy. Conclusion The study indicates that the early invasive approach may be the preferred strategy in patients with unstable angina or non-Q wave myocardial infarction.  相似文献   

2.
Background Many patients with acute coronary syndrome (ACS) develop recurrent angina (RA) during hospitalization. The aim of this non-randomized, prospective study was to investigate the predictive factors of RA in unselected patients with ACS enrolled in the global registry acute coronary events (GRACE) during hospitalization in China.Methods Between March 2001 and October 2004., enrolled were 1433 patients with ACS, including ST segment elevation myocardial infarction (662, 46.2%), non-ST segment elevation myocardial infarction (239, 16.7%) and unstable angina (532, 37.1%). The demographic distribution, medical history and clinical data were collected to investigate the predictive factors of RA by Logistic regression. Results During hospitalization 275 (19.2%) patients were documented with RA including unstable angina (53.2%), non- ST segment elevation myocardial infarction (27.5%), ST segment elevation myocardial infarction (19.3%). A comorbidity of dyslipidemia, prior angina, percutaneous coronary intervention (PCI) within 6 months was more common in patients with RA, P〈0.05. In the patients with RA, a significantly higher proportion of patients with acute pulmonary edema was observed, 23 (8.4%) versus 43 (3.7%), P=0.001. Acute renal failure was present in 8 (2.9%) of patients with RA versus 19 (1.6%) of patients without RA, P=0.165. Hemorrhagic events were present in 6 (2.2%) of patients with RA versus 8 (0.7%) of patients without RA, ventricular tachycardia/ventricular fibrillation events in 12 patients (4.3%) versus 22 patients (1.9%), congestive heart failure in 69 patients (25.0%) versus 94 patients (8.1%), myocardial re-infarction in 28 patients (10.1%) versus 15 patients (1.3%), P〈0.05, respectively. A lower proportion of patients with RA underwent in-hospital PCI 687 (59.3%) versus 114 (41.5%), P=0.000. A higher proportion of patients with RA received heparin, 260 (94.5%) versus 1035 (89.4%)  相似文献   

3.
Background The clinical outcome of percutaneous coronary intervention (PCI) is poorer in women than that in men. This study aimed at comparing the impact of gender difference on the strategy of primary PCI in patients with acute ST-segment elevation myocardial infarction (STEMI).
Methods Two hundred and fifty-nine patients with STEMI who underwent primary PCI within 12 hours of symptom onset were enrolled. The male group consisted of 143 men aged 〉55 years, and a female group included 116 women without age limitation. Procedural success was defined as residual stenosis 〈20% with thrombolysis in myocardial infarction flow grade 〉2 and without death, emergency bypass surgery or disabling cerebral events during the hospitalization. The rate of major adverse cardiac events (MACE), including death, nonfatal myocardial infarction and target vessel revascularization during follow-up, was recorded.
Results Female patients were more hypertensive and diabetic and with fewer cigarette smokers than male counterparts. The prevalence of angiographic 3-vessel disease was higher in the female group, but the procedural success rate was comparable between the two groups (94.4% vs 92.2%). The occurrence rate of MACE did not differ during the hospitalization (4.2% vs 6.0%, P=0.50), but was significantly higher in the female group during follow-up (mean (16.0±11.2) months) than that in the male group (5.4% vs 0.7%, P=0.02).
Conclusion Despite a similar success rate of primary PCI and in-hospital outcomes in both genders, female patients with acute STEMI still have a worse prognosis during the long-term follow-up.  相似文献   

4.
Objective Rosiglitazone, an agonist of peroxisome proliferator-activated receptor-γ (PPARγ), is an insulin- sensitizing antidiabetic agent and inhibits restenosis in animal blood vessels. This study was designed to investigate its effects on clinical outcomes of patients with type 2 diabetes and coronary artery disease (CAD) after percutaneous coronary intervention (PCI). Methods Patients with diabetes and CAD who had undergone PCI were randomly assigned to a rosiglitazone group or a control group. Patients in the rosiglitazone treatment group were treated with rosiglitazone 1 day before PCI (4mg once daily) and treatment was continued until the 6 months follow-up; while in the control group, patients were treated with placebo 1 day before the procedure and until the 6 months follow-up. Adverse events were death, myocardial infarction and urgent target vessel revascularization within 6 months after PCI. Results Seventy patients in the rosiglitazone group and 66 patients in the control group survived during the follow-up. Baseline characteristics among patients in the two groups were well balanced. There was no significant difference in target vessels or the procedure of stent implantation. Compared with the control group, treatment with rosiglitazone was associated with a lower rate of death, myocardial infarction and urgent target vessel revascularization (5.7% vs 19.7%, P=0.013). Conclusion Rosiglitazone could reduce the risk of the adverse cardiovascular event and improve clinical outcomes in type 2 diabetes with coronary artery disease after PCI.  相似文献   

5.
Objective: The aim of the present study was to assess the early clinical outcome and risk factors in old patients with acute ST elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (PCI). Methods: A total of 136 patients older than 60 years with STEMI who received successful PCI were included in this study. The patients were classified in 2 age groups: patients 〉75 years and 〈75 years of age. The extent of coronary artery lesions was measured by quantitative coronary artery angiography (QCA). Subjects were tracked for subsequent cardiovascular events: cardiac death, myocardial infarction, heart failure, percutaneous coronary intervention, coronary artery bypass and stroke. Results: Though the older group had a higher prevalence of adverse baseline characteristics and lower final TIMI flow than patients〈75y (P〈0.05), the procedural success did not make difference between the two groups. In 12 months follow-up of 136 study participants, there occurred 39 CV events : cardiac death (five patients), heart failure (nineteen patients), and stroke (six patients). Three patients received coronary bypass grafts and six patients underwent PCI. Heart failure and overall cardiovascular event rates were higher in older patients compared with those in patients〈75y. The main adverse clinical events (MACE) for the old group were a little higher comparing with the younger in 12-month follow-up (P=-0.029 6 and P=-0.043 4). Multivariate cox analysis identified that a diagnosis of diabetes (HR 2.495, 95%CI 1.224 to 5.083, P= 0.011 8) and time from symptom(HR 1.450, 95%CI 1.143 to 1.841, P= 0.008 2) to PCI as independent predictors of CV events after adjustment of all entered baseline variables. Conclusion: Our study suggests that drug-eluting stent implantation in older patients with acute ST elevation myocardial infarction has high initial procedural success rates despite having more severe baseline risk characteristics, and to shorten the time from symptom onset to PCI may decrease cardiovascular events in old patients following PCI.  相似文献   

6.
Objective To investigate relationship between serum level of brain natriuretic peptide (BNP)and short-term prognosis in patients with acute myocardial infarction(AMI).Methods Ninetynine patients with AMl with elevated S-T segment in electrocardiogram admitted to the department of cardiology,the Fourth Hospital of Jilin University,Changchun during January to December 2008 were divided into two groups.one with percutaneous transluminal coronary angioplasty(PTCA)or pereutaneous coronary intervention(PCI)(61 eases)and the other without PTCA(38 cases)as controls.Their serum levels of BNP were measured at admission, and one day and seven days after admission,respectively,and their main adverse cardiac events(MACE)were followed-up and recorded for 30 days.Results No significant differenee in serum BNP level between the patients at admission and one day after admission was found(P<0.01).Seven days after admission,serum BNP level in PCI group was significantly lower than that in controls(P<0.01),and occurrence of MACE was significantly lower in PCI group than that in controls(P<0.05).Logistic regression analysis indicated that serum BNP level in PCI group seven days after admission was the uppermost predictor for MACE in patients with AMI in one month after onset(OR=1.026,95%CI 1.014-1.038,P<0.01).Serum BNP level was significantly higher in patients with MACE seven days after admission than that in those without it(P<0.01)during 30-day followup.Conclusion Serum level of BNP seven days after admission is associated with their short-term prognosisfor patients with AMI.  相似文献   

7.
Objective To investigate relationship between serum level of brain natriuretic peptide (BNP)and short-term prognosis in patients with acute myocardial infarction(AMI).Methods Ninetynine patients with AMl with elevated S-T segment in electrocardiogram admitted to the department of cardiology,the Fourth Hospital of Jilin University,Changchun during January to December 2008 were divided into two groups.one with percutaneous transluminal coronary angioplasty(PTCA)or pereutaneous coronary intervention(PCI)(61 eases)and the other without PTCA(38 cases)as controls.Their serum levels of BNP were measured at admission, and one day and seven days after admission,respectively,and their main adverse cardiac events(MACE)were followed-up and recorded for 30 days.Results No significant differenee in serum BNP level between the patients at admission and one day after admission was found(P<0.01).Seven days after admission,serum BNP level in PCI group was significantly lower than that in controls(P<0.01),and occurrence of MACE was significantly lower in PCI group than that in controls(P<0.05).Logistic regression analysis indicated that serum BNP level in PCI group seven days after admission was the uppermost predictor for MACE in patients with AMI in one month after onset(OR=1.026,95%CI 1.014-1.038,P<0.01).Serum BNP level was significantly higher in patients with MACE seven days after admission than that in those without it(P<0.01)during 30-day followup.Conclusion Serum level of BNP seven days after admission is associated with their short-term prognosisfor patients with AMI.  相似文献   

8.
Objective To evaluate the efficiency and safety of PercuSurge DPD in coronary intervention in patients with acute myocardial infarction undergoing PCI treatment within 72 hours. Methods This was a prospective cohort study of patients with AM. From December 2003 to December 2005, 174 acute myocardial infarction patients who received primary coronary intervention were included into this study. Patients were divided into DPD and control group according to whether Percusurge DPD was attempted during emergency PCI. The basic clinical characteristics, angiographic results, and follow up data before discharge were compared. TIMI flow grades and myocardial blush grades were performed in all cases after emergency PCI. Results The device was successfully deployed in 78 of 87 patients, the visible red, white debris or red clastic thrombosis were aspirated in 72 of 78 patients in DPD group. Post- PCI Thrombolysis in Myocardial Infarction (TIMI) grades and myocardial blush grades were significantly higher in DPD group than in control group. Post-PCl no-reflow, distal embolization and 30-day major adverse cardiac events were significantly higher in control group than in DPD group, whereas TIMI grades, myocardial blush grades and minimal lumen diameter were significantly increased after using the export aspiration. Conclusion PercuSurge DPD can be used safely and effectively in coronary intervention in the thrombus laden arteries such as AMI.  相似文献   

9.
Background Many studies have examined gender related differences in the presenting symptoms, management and prognosis of patients with acute coronary syndrome (ACS). Much data are available from industrialized countries, in which ACS is a major cause of morbidity and mortality, but relatively little information has been obtained from China, where an epidemic of cardiovascular disease is starting to emerge. The purpose of this study was to assess the differences in clinical practice in a national Chinese sample.Methods A total of 12 medical teaching hospitals participated in CRACE. Data collection began in 2001 and continued until 2004, 1301 patients with ACS were enrolled into the study. We compared the clinical demographics, different therapies and outcomes in hospitals between female and male patients with ACS.Results Patients had an average age of 63.13 years (ranging from 27 to 93 years) and 318 female and 983 male subjects were enrolled. Female subjects were older than male patients (67.23 years vs 61.80 years, P<0.0001). The incidence of angina, heart failure, diabetes mellitus and hypertension in the female group was higher than in male group (73.6% vs 62.3%, P<0.0001; 8.2% vs 5.7%, P=0.031; 30.8% vs 18.6%, P<0.0001 and 66.4% vs 56.8%, P=0.001 respectively), but the incidence of smoking was less in the female group than in the male group (6.6% vs 66.2%, P<0.0001). More male patients presented with ST-segment elevation myocardial infarction (STEMI) compared with female patients (48.5% vs 39%, P=0.002). With the exception of β-blocker administration, no differences were found among medications including aspirin, ACEI, lipid lowering agents and low-molecular-weight heparin (LMWH) between female and male patients presenting with ACS in hospitals. Compared with male patients with non-ST-segment elevation (NSTE) ACS, female subjects were more prone to receive β-blockers (75.1% vs 63.4%, P=0.001). Among STEMI and NSTE-ACS patients, fewer female subjects received reperfusion therapy compared with male subjects (37.1% vs 26.8%, P=0.013 for STEMI; 53.6% vs 37.2 %, P<0.0001 for NSTE-ACS). Recurrent angina was more often seen in the female group of patients with the whole spectrum of ACS (25% vs 14.5%, P=0.005 for STEMI; 29.4% vs 20.2%, P=0.001 for NSTE-ACS) as was true for patients with congestive heart failure. There was no significant difference in in-hospital death rates between the two groups with ACS (5.6% vs 7.1%, P=0.2 for STEMI, and 2.1% vs 1.4%, P=0.738 for NSTE-ACS). Conclusions Female patients with ACS were older than male subjects and thus more often had concomitant diseases but less often had a history of smoking. They less often received reperfusion therapies and more often had higher in-hospital recurrent angina. However, there was no significant difference in in-hospital mortality between the female and male patients.  相似文献   

10.
OBJECTIVE To assess the efficacy of captopril on mortality and morbidity after acute myocardial infarction (AMI).
METHODS A total of 14,962 patients entering 650 hospitals from 30 provinces and autonomous regions of China up to 36 hours (mean 16.6 +/- 10.2 hours) after the onset of suspected acute myocardial infarction (MI) with no clear contraindications or indications to the study treatments (in particular, no persistent hypotension or hypovolemia due to long-term use of large dose of diuretics) were randomized to use either 4 weeks of oral captopril (6.25 mg initial dose, 12.5 mg 2 hours later, and then 12.5 mg three times daily) or matching placebo.
RESULTS Captopril was associated with a non-significant reduction in 4-week mortality (9.12% vs 9.74%; P = 0.20); but incidence of heart failure was significantly reduced among captopril group (17.0% vs 18.7%; P = 0.01). The combined end point (death + heart failure) was 1680 (21.5%) in captopril group and 1733 (23.1%) in placebo group (P = 0.02). Anterior wall infarction of captopril treated group was found to have lower mortality (8.6% vs 10.2%, P = 0.02). Captopril treated group with a heart rate (HR) > or = 60/min at entry showed significantly lower mortality than placebo group (9.2% vs 10.7%; P = 0.01). There was a significant excess of hypotension, mostly after the start of treatment, but no evidence of any adverse effect on early mortality.
CONCLUSIONS The angiotensin converting enzyme inhibitors (CEI) therapy started early in acute MI prevents about 6 deaths per 1000 treated, and about 15 deaths due to heart failure per 1000 in the 1st 4 weeks with greater benefits. In anterior myocardial infarction group it prevents 16 deaths per 1000 with nearly no benefit for the inferior infarction group. Due to the parasympathetic mimic effect, CEI should be used carefully in inferior infarction patients especially when HR is slow or heart block and hypotension are present.
  相似文献   

11.
目的:分析急性冠脉综合征(ACS)患者早期B型钠尿肽(BNP)水平的差异,评估BNP在早期诊断中的作用。方法:入选末次症状发作至就诊时间均〈6h的ACS患者221例.分为ST段抬高心肌梗死(STEMI)组(n=83)、非ST段抬高心肌梗死(NSTEMI)组(n=69)和不稳定性心绞痛(UA)组(n=69)。所有患者在入院即刻测定BNP水平,发病12h内测定肌钙蛋白Ⅰ(TnⅠ)。比较不同组间BNP的差别及BNP与TnⅠ的相关性。结果:UA、NSTEMI和STEMI患者基础血浆BNP浓度依次升高(分别为13.9pg/ml、34.9pg/ml和64.2pg/ml)(组间比较P〈0.01),且STEMI和NSTEMI患者BNP水平与TnⅠ正相关(叫分别为0.724和0.675,P均〈0.01)。BNP≥100pg/ml对NSTEMI诊断阳性预测值达83.3%。结论:ACS患者早期BNP水平升高.对早期鉴别NSTEMI和UA有一定价值.  相似文献   

12.
目的 研究冠心病患者血浆脑钠肽(BNP)浓度的差异,急性冠脉综合征(ACS)患者血浆BNP浓度与肌钙蛋白I(cTnI)的相关性,并探讨BNP对ACS危险分层的价值.方法 用酶联免疫吸附法(ELISA)检测了78例ACS患者、42例稳定型心绞痛(SAP)及30例非冠心病健康对照组的血浆cTnI、BNP水平,分析ACS组患者血浆BNP与cTnI的关系;随访120例冠心病患者60 d,观察终点为心肌梗死新发或再发、出现或心衰恶化和心源性猝死.结果 血浆BNP在ACS组(138.10±4.85)pg/ml明显高于SAP组(30.62±1.08)pg/ml及对照组(29.27±1.45)pg/ml(P均〈0.05).SAP组和对照组BNP浓度差异无统计学意义(P>0.05).ACS中cTnI阳性组血浆BNP浓度(152.21±1.86)pg/ml高于cTnI阴性组(78.10±1.85)pg/ml(P〈0.01),血浆BNP浓度与cTnI浓度呈正相关(r=0.57,P〈0.05).120例冠心病患者中BNP〉80 pg/ml组较BNP≤80 pg/ml组有更高的心肌梗死新发或再发率以及心衰发生或恶化率.结论 ACS组血浆BNP浓度升高,并与cTnI呈正相关;BNP对ACS患者近期预后有重要的临床价值,可作为危险分层的指标.  相似文献   

13.
廖伟  张义效  周爱琴 《陕西医学杂志》2009,38(12):1630-1631
目的:探讨急性冠状动脉综合征(ACS)患者行经皮冠状动脉介入治疗(PCI)术后48h血浆脑钠肽(BNP)水平变化与近、远期心血管事件关系。方法:对92例ACS患者常规进行术前和术后治疗并规范化行PCI术,术后48h行BNP测定,A组血浆BNP水平>80pg/ml,B组血浆BNP水平<80pg/ml;观察两组住院期间及术后6个月心血管事件发生率。结果:A组住院期间心血管事件发生率明显高于B组(P<0.01);但两组术后6个月心血管事件发生率无明显差异(P>0.05)。结论:ACS患者行PCI术,术后48hBNP浓度仅能预测近期预后而对远期预后无明显的预测作用。  相似文献   

14.
目的:观察ST段抬高的急性心肌梗死(STEAMI)患者接受急诊直接冠状动脉介入治疗(PCI)后的脑利钠肽(BNP)水平对长期预后价值的应用。方法:连续入选2009年1月~2011年1月之间,发病后12小时之内接受急诊直接PCI治疗的ST段抬高的急性心肌梗死患者184例,采用荧光免疫抗原抗体结合方法测定发病后24小时血浆BNP水平。根据BNP浓度分为3组:A组<100pg/mL,B组100~400pg/mL,C组>400pg/mL。收集住院期间的临床资料,并随访1年。结果:①冠状动脉造影结果中B组、C组多支血管病变比例明显高于A组(P<0.01)。②1年内病死率C组明显高于A、B组(P<0.01),进行多因素logistic回归分析,血浆BNP浓度是AMI后1年病死率的独立预测因子。结论:接受急诊直接冠状动脉介入治疗的ST段抬高的急性心肌梗死患者的早期血浆脑利钠肽水平可作为1年后病死率的预测因子。  相似文献   

15.
摘 要: 目的 进一步探讨急性右心室心肌梗死并左心室下壁、前壁梗死直接和延迟经皮冠状动脉介入治疗(PCI)对血浆脑利钠肽(BNP)水平及心室重构的影响。方法 急性右心室心肌梗死并左心室下壁、前壁梗死患者207例,分为急性右心室梗死并左心室下壁梗死组和急性右心室梗死并左心室前壁梗死组。分别比较二组患者PCI治疗前血浆BNP水平、心肌酶、血流动力学及冠状动脉病变特点;比较直接和延迟PCI治疗前后血浆BNP水平、左室射血分数(LVEF)、左室舒张末期内径(LVEDd)变化的意义。结果 急性右心室心肌梗死并左心室前壁梗死组PCI治疗前血浆BNP水平高、肌酸激酶(CK) 峰值及肌酸激酶同工酶(CK-MB)峰值高、肺动脉收缩压高、梗死相关冠状动脉狭窄程度及2支病变发生率高与急性右心室心肌梗死并左心室下壁梗死组比较差异有统计学意义(P <0.05)。直接和延迟PCI治疗后均能使血浆BNP水平及LVEDd较术前下降(P<0.05),但直接PCI治疗术后血浆BNP水平更低、LVEDd改善更明显(P<0.05)。未行PCI治疗的死亡发生率明显高于行直接PCI及延迟PCI治疗的患者,差异有统计学意义(P<0.05)。结论 急性右心室心肌梗死并左心室前壁梗死血浆BNP水平高,梗死相关冠状动脉病变严重;直接PCI治疗后心室重构改善明显,血浆BNP水平下降显著;未行PCI治疗的患者死亡率高。  相似文献   

16.
Zhang J  Qiao SB  Zhu J  Chen J  Yang WX  Liang Y  Shao SL  Zhang WJ  Liu R 《中华医学杂志》2010,90(30):2094-2098
目的 比较非ST段抬高急性冠状动脉综合征患者介入治疗的性别差异.方法 为多中心随机研究,在全国24家医院,根据入选标准将非ST段抬高的急性冠状动脉综合征患者随机分配至早期介入组(24 h内接受冠状动脉造影)和延迟介入组(36 h后接受冠状动脉造影).分别观察介入治疗后不同性别的主要终点事件(180 d随访时死亡、心肌梗死、卒中的复合终点),次要终点事件(180 d随访时死亡、心肌梗死、难治性缺血、卒中、再次血运重建).结果 共有815例患者入选,其中男性545例,女性270例.男性和女性患者主要终点和次要终点事件发生率差异无统计学意义(P>0.05).男性患者早介入组主要终点事件发生率明显低于延迟介入组(分别为7.1%、14.8%,P=0.00);两组次要终点事件发生率,即180 d随访时死亡、心肌梗死或难治性心肌缺血发生率分别为12.5%、21.2%,差异有统计学意义(P=0.00);另一个次要终点事件发生率,即180 d随访时死亡、心肌梗死、卒中、难治性心肌缺血或再次血运重建发生率分别为26.8%、32.4%,两组差异无统计学意义(P>0.05).女性早期介入组和延迟介入组间主要终点事件发生率(分别为12.6%、14.3%,P>0.05)和两个次要终点事件发生率(分别为18.5%、23.5%,P>0.05;28.5%、27.7%,P>0.05)差异均无统计学意义.结论 男性和女性非ST段抬高急性冠状动脉综合征患者介入治疗的疗效和安全性无明显差异;但男性患者早期介入治疗可减少心肌梗死的发生率,女性患者早期和延迟介入治疗均无明显差异.  相似文献   

17.
目的近年来,经皮冠状动脉介入术(percutaneous coronary intervention,PCI)广泛应用于临床,如何有效减轻心肌再灌注损伤是一项需要解决的问题。文中旨在观察磷酸肌酸钠(creatine phosphate,CrP)对急性冠状动脉综合征(acute cor-onary syndrome,ACS)患者PCI术后的心肌保护作用。方法 180例ACS患者成功行PCI术后随机分为治疗组90例[男53例、女37例,平均年龄(63.6±12.4)岁]和对照组90例[男56例、女34例,平均年龄(65.3±12.6)岁]。对照组于PCI术前、术后只给予ACS常规药物治疗,治疗组在常规药物治疗基础上于PCI术后静脉应用CrP治疗5 d。监测所有患者术前及术后血清中磷酸肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、乳酸脱氢酶(lactate dehydrogenase,LDH)、肌钙蛋白T(troporin T,cTnT)、超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdenyde,MDA)及一氧化氮(nitric oxide,NO)含量变化。结果治疗组术后血清中SOD含量明显高于对照组[41.2(10.3~168.2)pg/ml vs 32.4(10.5~96.8)pg/ml,P<0.01)];而血清MDA、LDH、CK-MB含量均明显低于对照组[3.22(1.00~7.84)pg/ml vs 3.67(0.58~9.82)pg/ml;156.2(84.0~703.5)U/L vs 176.5(94.0~983.7)U/L;11.0(5.0~104.0)U/L vs 14.5(5.0~196.5)U/L,P<0.01)];2组术后血清中cTnT及NO含量变化无明显差异[1.25(0.01~8.5)ng/ml vs 1.37(0.01~9.2)ng/ml;165.5(22.5~437.7)μmol/L vs159.6(20.3~414.4)μmol/L,P>0.05)]。结论 CrP对ACS患者PCI术后心肌具有一定保护作用。  相似文献   

18.
目的 探讨血浆脑钠肽(NBP)、高敏C反应蛋白(hs-CRP)水平对急性冠脉综合征(ACS)患者冠状动脉介入术(PCI)发生术中冠状动脉无复流的影响.方法 选择2014年6月至2016年12月在广元市第一人民医院接受PCI手术治疗的113例ACS患者,按照PCI手术是否发生术中冠状动脉无复流分为血流正常组78例与无复流组35例,比较两组患者术前、术后血浆NBP、hs-CRP水平,分析血浆NBP、hs-CRP水平与冠状动脉无复流的相关性.结果 术前血流正常组患者的BNP、hs-CRP水平分别为(91.82±30.21)pg/mL、(2.57±0.75)mg/L,术后分别为(91.31±28.05)pg/mL、(2.76±0.56)mg/L;无复流组患者术前分别为(122.36±30.83)pg/mL、(3.08±0.72)mg/L,术后分别为(155.72±47.64)pg/mL、(3.83±1.26)mg/L,手术前和手术后,血流正常组患者的BNP和hs-CRP水平均低于无复流组,差异均具有统计学意义(P<0.05);且无复流组患者手术后的BNP水平和hs-CRP水平均高于手术前,差异均具有统计学意义(P<0.05);经Pearson相关分析结果显示,血浆BNP及hs-CRP水平与PCI术后无复流之间呈高度正相关(r=0.752、0.805,P<0.05).结论 较高水平BNP、hs-CR能够诱导急性冠脉综合征患者PCI手术发生术中冠状动脉无复流,对于高水平的BNP、hs-CR急性冠脉综合征患者,应早期干预,以降低BNP、hs-CR水平,减少PCI术中冠状动脉无复流的发生.  相似文献   

19.
Background As an adipocytokine,resistin has been proposed as a link between inflammation,metabolic disorder and atherosclerosis.The aim of the study is to evaluate whether serum resistin is associated ...  相似文献   

20.
目的应用应变率成像技术评价早期、延期的经皮冠状动脉介入治疗(PCI)对急性心肌梗死患者局部心肌功能的影响。方法将30例ST段抬高型急性心肌梗死患者分为早期PCI组、延期PCI组,在PCI术前及术后1周、1个月、3个月分别测定收缩期、舒张早期、舒张晚期的应变率峰值(SR)。结果早期PCI组:PCI术后1个月及3个月的收缩期应变率峰值(SRS)、舒张早期应变率峰值(SRE)和舒张晚期应变率峰值(SRA)与术前间差异均有统计学意义(P<0.01);延期PCI组:术后3个月的SRE与术前间差异有统计学意义(P<0.05)。结论应变率成像可定量评价急性心肌梗死患者早期、延期PCI后局部心肌功能的变化。  相似文献   

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