冠脉介入治疗后肌钙蛋白升高的原因及其临床意义

Causes of Rise of Troponin after Percutaneous Coronary Intervention and its Clinical Implication

目的分析造成冠脉介入治疗后心肌损伤标志物升高的各临床因素,并探讨心肌损伤标志物升高对患者临床预后的影响。方法以129例择期行冠脉介入治疗且心脏特异性肌钙蛋白I(CTnI)基线正常的患者为研究对象,术后复查CTnI水平,并进行院内随访,观察患者临床结局。结果边支丢失或血流受损,无复流或慢血流现象以及糖尿病是术后患者CTnI升高的预报因子。CTnI升高组的心肌梗塞率高于CTnI正常组,临床观察发生心绞痛症状者亦较多,且住院时间明显延长。结论介入术后心肌损伤标志物CTnI升高与复杂病变和介入操作并发症有关,并能在一定程度上决定患者的预后。

Objective To analyse the clinical factors that contribute to the rise of the cardiac injury marker troponin after coronary intervention and the impact of the rise of troponin on the clinical outcomes. Methods Troponin I was measured after elective coronary intervention in 129 patients whose baseline levels of troponin were normal. The clinical outcomes of the patients were follow-up. Results The rise of troponin I was associated with side branch losses, flow impairments such as no flow or slow flow and diabetes. The incidence of myocardial infarction increased with the rise of troponin I. The angina onsets were more common and the length of stay were longer in the patients with the rise of troponin I than those without. Conclusion The rise of troponin after coronary intervention is related to the complex coronary lesions and the complications of intervention procedures. To a certain extent, the level of troponin can predict the patients＇ outcomes.