摘要
目的：探讨冠心病介入治疗术（PCI）后血清缺血修饰蛋白（IMA）、超敏 C 反应蛋白（hs-CRP）的水平变化，分析可能造成心肌缺血及损伤的原因。方法90例接受 PCI 治疗的患者在 PCI 术前30 min 及术后30 min、2 h、6 h、24 h 检测静脉血 IMA、hs-CRP，同时对冠脉病变指数及手术操作因素的差别进行分析。并进行院内随访，观察患者临床结局。结果 IMA 在术后30 min 开始明显升高（180±78）U ／L，与术前（52±14）U ／L 相比差异有统计学意义（t ＝2．293，P ＜0．05），术后2 h 出现峰值（276±164）U ／L，与术前（52±14）U ／L相比差异有统计学意义（t ＝1．116，P ＜0．01），hs-CRP 峰值于术后24 h 出现峰值（17．33±5．41）mg／L，较术前（6．12±2．12）mg／L 相比差异有统计学意义（t ＝3．678，P ＜0．01），IMA、hs-CRP 与术中球囊扩张时间总和（27．34±3．57）s、扩张次数（4．23±1．61）次、支架直径（3．13±0．40）mm、支架长度（24．55±6．65）mm 及支架数目方面密切相关，差异有统计学意义（r ＝0．967，P ＜0．05）。且 IMA 升高的患者住院时间明显延长。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和、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。并在一定程度上决定患者预后。
Objective To observe the changes of ischemia modified albumin （IMA）,high -sensitivity C -reactive protein （hs -CRP）after percutaneous coronary intervention （PCI）.The factors related to intervention procedures to patients with IMA and hs -CRP elevation after PCI and impact of the risk of IMA and hs -CRP on the clinical outcomes were investigated.Methods IMA,hs -CRP from vein blood of 90 cases received PCI were detec-ted before operation and after operation at time of 30 min,2h,6h and 24h.The clinical characteristics of patients and factors related to intervention procedures were recorded.The number of lesion vessels and the relative factors in PCI were compared.The clinical outcomes of the patients were followed up.Results After operation,IMA was significantly different compared with that before operation （t =2.293,P 〈0.05）.The concentration of IMA peaked at 2h after operation,which was significantly different from that before surgery （t =1.116,P 〈0.01）.The increase of IMA and hs -CRP were closely related with the inflation pressure,total times of inflation,dilated times,length and diameter of＆amp;nbsp;stent and the number of stents （t =3.678,P 〈0.01 ）.The angina onset was more common and length of stay was longer in the patients with the rise of IMA and hs -CRP.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.
出处
《中国基层医药》
CAS
2016年第22期3370-3373,共4页
Chinese Journal of Primary Medicine and Pharmacy
基金
河南省科学技术攻关项目（132102310222）
关键词
血管成形术
经腔
经皮冠状动脉
缺血修饰蛋白
C
反应蛋白质
心肌缺血
Angioplasty,transluminal,pevcutaneous coronary
Ischemia modified albumin
C -reactive protein
Myocardial ischemia
