不稳定心绞痛患者血浆肌钙蛋白T水平与冠状动脉病变程度及预后的关系

目的:探讨不稳定心绞痛(UA)患者血浆肌钙蛋白T(cTnT)水平与冠状动脉病变程度及预后的关系。方法:400例UA患者根据cTnT是否阳性分为cTnT阳性组(221例),cTnT阴性组(179例),在住院期间行冠脉造影(CAG)并观察其心脏事件的发生情况,对比分析两组UA患者的冠状动脉造影特点及预后。结果:cTnT阳性组冠状动脉造影阳性率为89.1%,3支病变发生率46.2%,冠脉内血栓形成者为21.8%,均明显高于cTnT阴性组;cTnT阳性组cTnT水平与冠状动脉的狭窄程度有相关性,cTnT阳性组近期(30 d)心脏事件发生率37.8%,亦明显高于cTnT阴性组,且两组对比有显著差异。结论:cTnT阳性的UA患者复杂病变多,冠脉内血栓形成率高,预后较差,cTnT水平越高,冠脉狭窄越重。

Relationship of Serum Troponin T Levels to the Severity of Coronary Artery Lesions and the Prognosis in the Patients with Unstable Angina Pectoris

Objective:To investigate the relationship of serum cardiac troponin T(cTnT)and the severity of coronary artery lesions and prognosis in patients with unstable angina pectoris.Methods:400 patients with unstable angina pectoris were divided into cTnT-positive group(221 cases)and cTnT negative group(179 cases)according to the level of cTnT.The coronary arte- riography was performed in all patients and cardiovascular events were observed.Coronary arteriography and cardiovascular e- vents were analyzed.Results:The positive rate of coronary arteriography was 89.1%,the occurrence of three vessel lesions was 46.2% and intracoronary thrombus was 21.8%,all were higher in cTnT-positive group than in cTnT-negative group.In cT- nT-positive group,the level of cTnT was associated with the degree of stenosis.There were significant difference in cardiovas- cular events between two groups(P<0.01).Conclusion:The cTnT-positive unstable angina patients had more complex lesions, intraeoronary thrombus and poor prognosis.There are positive relationship between the level of cTnT and the severity of stenosis.