冠心病PCI后肌钙蛋白T的变化及其临床意义

目的：探讨冠心病介入治疗后cTn—T的变化，分析cTn—T升高的相关因素及对病人临床预后的影响。方法：选择在我院成功行PCI手术的60例冠心病病人，测定PCI前、后24hcTn—T水平，并详细记录临床资料及PCI术中的相关操作因素，按照术后cTn—T升高与否，分为升高组（21例）和正常组（39例）。比较两组间冠脉病变支数及手术相关操作因素的差别。并进行院内随访，观察病人临床结局。结果：冠心病病人介入治疗后cTn—T升高率为35％，cTn—T升高组和cTn—T正常组在年龄、性别、体重指数、吸烟史、高血压史、糖尿病史、高血脂、病变血管支数方面的差别无统计学意义（P值〉0．05）。在支架释放及血管扩张时压力总合、球囊扩张时间总和、球囊扩张次数、支架长度、支架直径及支架数目方面的差别有统计学意义（P值〈O．05）。cTn-T升高组较cTn—T正常组，心纹痛症状发生者较多，且cTn—T升高组病人住院时间明显延长。结论：PCI术可引起心肌损伤，且与支架释放及血管扩张压力总合、球囊扩张时间总和、球囊扩张次数、支架数目、支架长度、支架直径有关。并能在一定程度上决定病人的预后。

CHANGES OF CARDIAC TROPONIN-T OF PATIENTS WITH CORONARY HEART DISEASE AFTER PERCUTANEOUS CORONARY INTERVENTION AND ITS CLINICAL IMPLICATION

Objective ： To observe the change of cardiac troponin - T （ cTn - T） after percutaneous coronary intervention（PCI）. The factors with related to intervention procedures to patients with cTn-T elevation after PCI and the impact of the risk of cTn-T on the clinical outcomes were investigated. Methods：60 patients were chosen after successful PCI in our hospital, cTn-T levels were measured before and at 24 h after the procedure,the clinical characteristics of patients and factors with related to intervention procedures were recorded. The patients with normal cTn-T before PCI were classified into group I （cTn-T positive,21 cases）and group Ⅱ （cTn-T negative,39 cases）by levels of cTn-T post intervention. Comparison about the number of lesion vessels and the relative factors in PCI were performed between two groups. The clinical outcomes of the patients were follow- up. Results： The positive rate of cTn-T was 35% after PCI. The differences in sex,age,BMI,history of smoking, ,hyper- tension,, diabetes mellitus, hyperlipidemia and the number of lesion vessels were no statistical significance between every two groups （P 〉0. 05 ）. There were statistical differences in inflation pressure ,total time of inflation, dilated times, length and diameter of stent and the number of stents between group I and group Ⅱ （P〈0. 05 ）. The angina onsets were more common and the length of stay were longer in the patients with the rise of cTn-T than those without. Conclusion： PCI may cause myocardial injury,which is associated to inflation pressure ,total time of inflation,dilated times,length and diameter of stent and the number of stents. To a certain extent the level of troponin Can predict the outcomes.