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|本期目录/Table of Contents|

冠心病患者PCI围手术期不同类别操作血管的特点及血清cTnI升高的相关因素

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2017年第1期
页码:
78-082
栏目:
临床研究
出版日期:
2016-10-05

文章信息/Info

Title:
Characteristics of surgery of different blood vessels in patients with coronary heart disease during perioperative period of PCI and related factors of elevated serum cTnI
作者:
邱 珺1; 吴 刚2; 张 冰2
（1.内蒙古医科大学研究生学院，内蒙古 呼和浩特 010110；
2.呼伦贝尔市人民医院心内科，内蒙古 海拉尔 021008）
Author(s):
QIU Jun1;  WU Gang2;  ZHANG Bing2
(1.Graduate College, Inner Mongolia Medical University, Inner Mongolia Autonomous Region, Hohhot 010110, Inner Mongolia, China；
2.Department of Cardiology, Hulunbuir People's Hospital, Inner Mongolia Autonomous Region, Hailaer 021008, Inner Mongolia,
关键词:
经皮冠状动脉介入治疗; 围手术期心肌梗死; 心肌肌钙蛋白I
Keywords:
percutaneous coronary intervention;  peri-procedural myocardial infarction;  cardiac troponin I
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 观察和分析冠心病患者经皮冠状动脉介入（percutaneous coronary intervention，PCI）治疗围手术期不同类别操作血管的特点及心肌肌钙蛋白I （cardiac troponin I,cTnI）升高的相关因素。方法 收集2014年3月~2015年11月，择期行PCI术的156例冠心病患者，根据操作血管分为前降支组（74例）、回旋支组（29例）和右冠脉组（53例），均为单支血管操作。根据术后cTnI变化情况将前降支组分为cTnI升高组（44例）和cTnI无变化组（30例）。所有患者均检测术前及术后3 h的cTnI，记录患者的各项基本资料、手术操作及术前血脂、血糖、肾功、离子等生化指标。结果 前降支组术后cTnI较术前显著升高（P<0.01），回旋支组及右冠脉组术后cTnI较术前无显著变化。3组间支架：总长度、平均直径、总释放压力、总释放时间；球囊：扩张次数、总释放压力、总释放时间、单次扩张最大压力、是否后扩张；手术时间差异有统计学意义（P<0.05）。cTnI升高组术前低密度脂蛋白胆固醇（LDL-C）、C反应蛋白（CRP）高水平所占百分比及球囊单次扩张最长时间明显高于无变化组（P<0.05）。结论 ①前降支病变患者PCI术后早期血清cTnI水平较术前明显升高；②术前LDL-C高水平、CRP高水平、球囊单次扩张最长时间可能为PCI术后早期cTnI升高的危险因素。
Abstract:
AIM To observe and analyze the correlation between postoperative cardiac troponin I levels and the effect of selective percutaneous coronary intervention (PCI) on patients with coronary heart disease. METHODSOne hundred and fifty-six patients undergoing elective PCI were enrolled between March 2014 and November 2015. Patients were divided into three groups according to coronary anatomy and lesion: LAD group (n=74), LCX group (n=29) and RCA group (n=53). Patients in LAD group were subdivided into two groups according to the levels of cTnI after operation: elevated group (n=44) and non-change group (n=30). Levels of cTnI were determined in all patients 3 h before and after PCI. Patients' basic data, surgical indicators and preoperative renal function, blood sugar, blood lipids, plasma and other biochemical markers were also recorded. RESULTSPostoperative cTnI levels increased significantly compared with those preoperative (P<0.01) in LAD group. No significant changes were found in LCX and RCA groups. Significant differences were found in the total length, mean diameter, total release pressure and total release time of stents, times of expansion, total release pressure, total release time, single expansion maximum pressure and whether to perform post-expansion of balloon, and in surgical time among the three groups. Proportion of preoperative high levels of LDL-C and CRP and single expansion maximum time of balloon in elevated group were significantly higher than those in the non-change group. CONCLUSIONPostoperative cTnI increases significantly compared with the preoperative value (P<0.05) in patients with LAD lesions. The preoperative high level of LDL-C, high level of CRP and single expansion maximum time of balloon may be predictors of the increase of cTnI after PCI.

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备注/Memo

备注/Memo:
收稿日期：2015-12-27.
通讯作者：吴刚，主任医师，主要从事心脏病的介入治疗及研究 Email：wugang921@sohu.com
作者简介：邱珺，硕士生 Email：864946797@qq.com
更新日期/Last Update: 2016-10-09