入院时肌钙蛋白I水平对急性心肌梗死再灌注患者心功能影响

目的:探讨入院时心肌肌钙蛋白I(cTnI)水平对急性心肌梗死再灌注患者心功能的影响。方法:95例患者因ST段抬高的急性心肌梗死(STEAMI)行直接经皮冠状动脉成型术(PCI),根据入院时cTnI水平分成cTnI正常组(45例)和cTnI升高组(50例)。观察住院期间通过心脏超声检查的心脏收缩功能和抗心力衰竭药物使用情况。结果:患者的一般临床特征中,cTnI升高组入院时的胸痛持续时间长、CK-MB峰值高(P<0.05)。两组比较,cTnI升高组左室收缩末容积显著增大、左室射血分数显著降低、室壁瘤的发生率高(P<0.05),地高辛和利尿剂的使用率高(P<0.05)。结论:STEAMI患者入院时cTnI升高心脏收缩功能差,应密切观察心功能,及早采取措施防治急性心力衰竭。

Effect of Admission cTnI Levels on Cardiac Function of Patients with Acute Myocardial Infarction Referred to Reperfusion

Objective: To investigate the effect of admission cardiac troponin I (cTnI) levels on cardiac function of patients with ST elevation acute myocardial infarction(STAEMI) to primary percutaneous coronary intervention(PCI).Method: 95 cases with STEAMI who underwent primary PCI were divided into 2 groups,normal cTnI group and elevating cTnI group,according to the admission cTnI levels.During hospitalizion,ultrasonic cardiogram and use of digoxin and duretics were observed.Result: Compared with nomal cTnI group,durations of chest pain before admission were longer and peak CK-MB levels were higher(both P<0.05).In elevating cTnI group,left ventricular end-systolic volumes were larger,ejection fractions of left ventricles were lower,the rates of ventricular aneurysm and the rates of use of digoxin and diuretis were higher than those of normal cTnI group.Conclusion: High admission cTnI levels were associated with poor cardiac function in patients with ST elevation acute myocardial infarction(STAEMI) to primary percutaneous coronary intervention(PCI).We should pay more attention to those patients to avoid onset of acute cardiac failure.