不稳定性心绞痛经皮冠状动脉介入术后内脂素与肌钙蛋白I变化及意义

目的探讨不稳定性心绞痛（UAP）患者经皮冠状动脉介入治疗（PCI）前后血清内脂素（Visfatin）及肌钙蛋白I（cardiacTroponinI，cTnI）水平变化及临床意义。方法选择108例UAP经PCI的患者，分别在术前，术后24、72h及50d测定血清Visfatin水平及cTnI水平。入选同期52例冠脉造影正常者作为对照组。随访3年，观察术后主要心脏不良事件（MACE）发生与Visfatin和cTnI水平之间的关系。结果UAP患者Visfatin和cTnI水平PCI术后24h较术前明显升高（P=0．01）；Visfatin水平在术后30d与术前差异无统计学意义（P=0．12）；cTnI水平在术后30d显著低于术前水平（P=0．02）；Visfatin与cTnI水平呈正相关（r=0．523，P=0．01）；发生MACE的PCI患者术后血清Visfatin与cTnI水平明显高于未发生MACE患者（P：0．03）；Visfatin与cTnI是MACE独立危险因素（OR=3．27，2．85，P〈0．05）。结论UAP患者PCI术后血清Visfatin与cTnI水平均一过性升高，且与发生MACE相关，两者在UAP患者PCI术后发生MACE的预测方面均有一定价值。

Clinical significance of visfatin and cTnI in patients with unstable angina pcetoris after coronarystent implantation

Objective To investigate the changes and clinical significance of serum visfatin and cardiac troponin I （cTnI） level in patients with unstable angina pectoris （UAP） after percutaneous coronary intervention （PCI）. Methods The 108 patients （ aged 51 NS0 years ） with UAP and 52 healthy subjects （ aged 48 - 75 ） were enrolled. Before and after PCI at the different time, the serum levels of visfatin and cTnI were analyzed. During three years followed-up, the major adverse cardiac events （MACE） were as- sessed. MACE defined as cardiac death, myocardial infarction, target lesion revascularization anginal sta- tus. Results Twenty four hours later after PCI, compared with the level before PCI, the serum visfatin and cTnI levels of the UAP group were significantly increased （ P = 0.01 ） ; the serum Visfatin levels of the UAP group before PCI and 30 days later after PCI had no significant difference（ P =0. 12） ; Thirty days later after PCI,the serum cTnI levels of the UAP group were lower than them before PCI （ P =0.02） ; high level visfatin and cTnI were independent predictors of MACE in UAP after PCI（ OR =3.27,2. 85） （ P 〈 0. 05）. The serum cTnI and visfatin levels were significantly positive correlation （ r =0. 523, P =0.01 ）. Conclusions The serum visfatin and cTnI levels in patients with UAP after PCI increased transitorily, and they had certain value in predicting MACE.