经皮腔内冠状动脉成形术前后血清肌钙蛋白T变化

Changes of Serum Troponin T Levels after Percutaneous Transluminal Coronary Angioplasty

23例冠心病患者，分别在行PTCA术前、术后第10小时、第2、3及第4天，采用自动Elisa法测定血清肌钙蛋白T（TnT）浓度。结果：（1）23例患者平均TnT水平，在PTCA后第10小时升高，第2天达峰值（为术前的4．7倍）第3、4天回降至术前水平（但P均＞0．05）；同时CK－MB升高不明显。（2）10例TnT明显升高（≥正常x＋2s）的患者比起另13例，TnT最高值比基线水平的增幅较大（10．2比1．8倍），与PTCA扩张总时间长、气压大以及基础病变不同有关。提示PTCA术对心肌损伤轻微；TnT为较灵敏而特异的心肌损伤的监测指标。

To observe the changes of serum troponin T (TnT) levels after percutaneous transluminalcoronary angioplasty (PTCA) in patients with coronary heart disease (CHD), inquire into its effect ofmyocardiac damage. By using of automatic ELISA,measured serum TnT levels in 23 cases of CHD under-going PTCA before,at 10th hour, 2nd day, 3rd and 4th day after the procedure respectively. (1) AfterPTCA,the serum TnT levels of 23 cases rised at 10th hour,reached the peak level at 2nd day (4. 7 times ofbaseline) and returned to baseline levels during 3rd and 4th daylmeanwhile,no obviously raise for CK-MBlevels. (2) The TnT levels of ≥x+2s (0. 93μg/L) levels appeared in 10 cases (43. 5% ),and their ampli-tude increased significantly than another 13 cases (10. 2 vs. 1. 8 times compared with baseline by itself),which may result from longer time of operation and higher baloon's pressure or basic disease differ-ent. While there was only one case showed CK-MB level increased over normal range for the group of TnTrised. Generally,PTCA may cause minor damage of myocardium ;TnT serum levels are more sensitive andspecific for monitoring myocardiac injury.