探讨冠心病PCI术后心肌肌钙蛋白I升高的临床价值(1)
【摘要】 目的 探討冠心病经皮冠状动脉介入治疗(PCI)术后心肌肌钙蛋白I(cTnI)值升高对患者临床预后的影响。方法 选择接受PCI术的119例冠心病患者， 监测PCI手术前后cTnI的水平， PCI术前cTnI水平正常者56例(47.1%)， 术前cTnI水平升高者63例(52.9%)；PCI术后cTnI升高者33例(27.7%)。按cTnI的水平将患者分为cTnI术前术后均正常组(Group Ⅰ组， 51例)， cTnI术前正常术后升高组(Group Ⅱ组， 5例)， cTnI术前术后升高组(Group Ⅲ组， 30例)。记录PCI术后各组间心脏事件的发生率并进行比较。结果 Group Ⅰ组中心律失常发生率为7.8%(4/51)， Group Ⅱ组为60.0%(3/5)， Group Ⅲ组为56.7%(17/30)；而三组急性心力衰竭的发生率分别为3.9%， 40.0%， 46.7%；住院期间三组均无死亡病例；Group Ⅱ组 和Group Ⅲ组急性心力衰竭和心律失常的发生率明显高于Group Ⅰ组(P<0.05)， 由此可以得出PCI术后cTnI升高与住院期间患者心脏时间的发生率明显相关。Group Ⅲ组和Group Ⅱ组30 d
内死亡率高于Group Ⅰ组， 差异有统计学意义(P<0.05)。PCI术后随访1年， Group Ⅲ组二次返院率和死亡率高于Group Ⅰ组(P<0.05)；Group Ⅲ组和Group Ⅱ组再次PCI率和行CABG率高于Group Ⅰ (P<0.05)。结论 cTnI对于预测PCI术后心脏事件的发生有一定的价值。
【关键词】 冠心病；经皮冠状动脉介入治疗；心肌肌钙蛋白I
DOI：10.14163/j.cnki.11-5547/r.2017.18.010
【Abstract】 Objective To explore the impact of elevated cardiac troponin I (cTnI) value after percutaneous coronary intervention (PCI) on clinical prognosis of patients. Methods A total of 119 coronary heart disease patients undergoing PCI were selected to monitor the levels of cTnI before and after PCI， and there were
56 cases (47.1%) with normal cTnI level before PCI， 63 cases (52.9%) with increased cTnI level before PCI， and 33 cases (27.7%) with increased cTnI level after PCI. They were divided by cTnI levels into normal cTnI before and after operation group (Group Ⅰ， 51 cases)， normal cTnI before operation and elevated cTnI after operation group (Group Ⅱ， 5 cases) and elevated cTnI before and after operation (Group Ⅲ， 30 cases). Record and analysis were made on incidence of cardiac events in groups after PCI. Results Group Ⅰ had incidence of arrhythmia as 7.8% (4/51)， which was 60.0% (3/5) in Group Ⅱ and 56.7% (17/30) in Group Ⅲ. Three groups had incidence of acute heart failure respectively as 3.9%， 40.0% and 46.7%， and no death case showed during hospitalization. Group Ⅱ and Group Ⅲ had obviously higher incidence of acute heart failure and arrhythmia than Group Ⅰ (P<0.05)， and it can be concluded that cTnI elevation after PCI is significantly correlated with the incidence of cardiac events during hospitalization. Group Ⅲ and Group Ⅱ had higher death rate within 30 d than Group Ⅰ， and the difference had statistical significance (P<0.05). Follow-up after PCI for 1 year showed that Group Ⅲ had higher second hospital return rate and death rate than Group Ⅰ (P<0.05). Group Ⅲ and Group Ⅱ had higher second PCI rate and CABG rate than Group Ⅰ (P<0.05). Conclusion cTnI shows certain value for prediction of occurrence of cardiac events after PCI., http://www.100md.com(盘庆飞 黄贤 何秀丽)
内死亡率高于Group Ⅰ组， 差异有统计学意义(P<0.05)。PCI术后随访1年， Group Ⅲ组二次返院率和死亡率高于Group Ⅰ组(P<0.05)；Group Ⅲ组和Group Ⅱ组再次PCI率和行CABG率高于Group Ⅰ (P<0.05)。结论 cTnI对于预测PCI术后心脏事件的发生有一定的价值。
【关键词】 冠心病；经皮冠状动脉介入治疗；心肌肌钙蛋白I
DOI：10.14163/j.cnki.11-5547/r.2017.18.010
【Abstract】 Objective To explore the impact of elevated cardiac troponin I (cTnI) value after percutaneous coronary intervention (PCI) on clinical prognosis of patients. Methods A total of 119 coronary heart disease patients undergoing PCI were selected to monitor the levels of cTnI before and after PCI， and there were
56 cases (47.1%) with normal cTnI level before PCI， 63 cases (52.9%) with increased cTnI level before PCI， and 33 cases (27.7%) with increased cTnI level after PCI. They were divided by cTnI levels into normal cTnI before and after operation group (Group Ⅰ， 51 cases)， normal cTnI before operation and elevated cTnI after operation group (Group Ⅱ， 5 cases) and elevated cTnI before and after operation (Group Ⅲ， 30 cases). Record and analysis were made on incidence of cardiac events in groups after PCI. Results Group Ⅰ had incidence of arrhythmia as 7.8% (4/51)， which was 60.0% (3/5) in Group Ⅱ and 56.7% (17/30) in Group Ⅲ. Three groups had incidence of acute heart failure respectively as 3.9%， 40.0% and 46.7%， and no death case showed during hospitalization. Group Ⅱ and Group Ⅲ had obviously higher incidence of acute heart failure and arrhythmia than Group Ⅰ (P<0.05)， and it can be concluded that cTnI elevation after PCI is significantly correlated with the incidence of cardiac events during hospitalization. Group Ⅲ and Group Ⅱ had higher death rate within 30 d than Group Ⅰ， and the difference had statistical significance (P<0.05). Follow-up after PCI for 1 year showed that Group Ⅲ had higher second hospital return rate and death rate than Group Ⅰ (P<0.05). Group Ⅲ and Group Ⅱ had higher second PCI rate and CABG rate than Group Ⅰ (P<0.05). Conclusion cTnI shows certain value for prediction of occurrence of cardiac events after PCI., http://www.100md.com(盘庆飞 黄贤 何秀丽)