心脏肌钙蛋白Ⅰ与急性心肌梗死患者血管成形术后预后关系的评价

Evaluation of the Relation Between Cardiac Troponin Ⅰand Prognosis After Angioplasty in Patients with Acute Myocardial Infarction

目的 探讨心脏肌钙蛋白Ⅰ水平对急性心肌梗死患者血管成形术后预后的评估价值。方法 连续行血管成形术的 10 2例急性心肌梗死患者 ,根据入院时肌钙蛋白Ⅰ水平将患者分为肌钙蛋白Ⅰ升高组和肌钙蛋白Ⅰ正常组 ,观察患者临床特征并随访 (平均 9.5± 7.5月 )主要心血管事件。结果 与正常肌钙蛋白Ⅰ组患者比较 ,肌钙蛋白Ⅰ升高组患者左心室射血分数明显下降 (P <0 .0 5 ) ;住院期间 ,肌钙蛋白Ⅰ升高组总主要心血管事件 (包括充血性心力衰竭、非致命性再次心肌梗死及死亡 )显著增高 (32 .8%比 18.4 % ,P <0 .0 5 ) ;追踪观察期间 ,肌钙蛋白Ⅰ升高组总主要心血管事件 (包括心脏性死亡、非致命性再次心肌梗死及靶血管血运重建 )显著增高 (2 9.7%比 15 .8% ,P <0 .0 5 )。结论 在急性心肌梗死患者中 ,入院时血心脏肌钙蛋白水平与血管成形术后的近期和远期不良预后相关 。

Aim To explore the predictive value of cardiac troponin Ⅰ(cTnⅠ) level on prognosis in patients with acute myocardial infarction (AMI)after angioplasty. Methods One hundred and two cases with ST elevation or new branch bond block (LBBB)who underwent consecutive angioplasty were divided into 2 groups: cTnⅠelevated group (64 cases)and cTnⅠnormal group (38 cases)according to the admission cTnⅠlevels. The clinical characteristics were observed and major cardiovascular events (MACE)at follow-up period of a mean 9.5±7.5 months were analysed. Results Compared with those in cTnⅠnormal group, the left ventricular ejection fractions (LVEF) decreased in cTnⅠelevated group (P<0.05); During clinical hospitalization, total rates of MACE (including overall incidences of congestive heart failure, non-fatal myocardial infarction and cardiac death) significantly increased in cTnⅠelevated group (32.8% vs 18.4%, P<0.05); in follow-up period, total rates of MACE (including overall incidences of non-fatal myocardial infarction, revascularization of target vessel and cardiac death) were significantly increased in cTnⅠelevated group (29.7% vs 15.8%, P<0.05). Conclusions cTnⅠlevel on admission was associated with adverse prognosis of short and long term in patients with AMI and is an independent predictor for total rates of MACE.