急性冠脉综合征急诊PCI心血管不良事件与血清肌钙蛋白水平的关系

目的 探讨急性冠脉综合征急诊经皮冠状动脉介入术(PCI)近期心血管不良事件与血清肌钙蛋白(cTnⅠ)水平的关系.方法 急性冠脉综合征急诊PCI手术患者125例,根据入院时即刻血清肌钙蛋白Ⅰ(cTnⅠ)水平将患者分为三组,其中cTnⅠ<0.02 ng/ml作为A组,cTnⅠ0.02~1 ng/ml作为B组,cTnⅠ>1 ng/ml作为C组,比较三组患者PCI术后30 d冠脉狭窄程度与心血管不良事件发生率.结果 B组和C组患者的病变支数、最大病变程度与Gensini评分均明显高于A组,其中C组最大病变程度与Gensini评分均明显高于B组,差异均有统计学意义(P<0.05);B组和C组患者的近期心血管不良事件发生率为32.6%和59.5%,明显高于A组的7.5%,差异均具有统计学意义(P<0.05).结论 血清肌钙蛋白水平升高程度越明显,急性冠脉综合征急诊PCI患者近期心血管不良事件发生风险越高,其可能与血清肌钙蛋白水平较高加重冠脉狭窄程度有关.

Relationship between serum troponin level and cardiovascular adverse events in patients with acute coronary syndrome treated by emergency percutaneous coronary intervention

Objective To investigate the relationship between cardiovascular adverse events and serum tropo-nin (cTn I) level in patients with acute coronary syndrome treated by emergency percutaneous coronary intervention (PCI). Methods One hundred and twenty-five patients of acute coronary syndrome treated by emergency PCI were selected, which were divided into three groups according to the serum cTnI level at admission, group A with cTnI<0.02 ng/ml, group B with cTnI 0.02~1 ng/ml, group C with cTnI>1 ng/ml. Degree of coronary artery stenosis and the incidence of adverse cardiovascular events 30 d after PCI were compared between the three groups. Results The number of lesions, maxi-mum degree of lesions and Gensini score in group B, group C were significantly higher than those in group A (P<0.05). The maximum degree of lesions and Gensini score in group C were significantly higher than group B (P<0.05). The inci-dence of recent adverse cardiovascular events of group B, group C were 32.6% and 59.5%, which were significantly higher than 7.5% of group A (P<0.05). Conclusion In patients with acute coronary syndrome treated by emergency PCI, the more significant the increase of serum cTnI levels, the higher the risk of recent adverse cardiovascular events. This might be related to the phenomenon that higher serum cTnI levels increase the degree of coronary artery stenosis.