经皮冠状动脉腔内成形术前后血清肌钙蛋白I的变化

Changes of Serum Cardiac Troponin I Levels After Percutaneous Transluminal Coronary Angioplasty

目的：通过动态观察血清心肌肌钙蛋白Ｉ（ｃＴｎＩ）及肌酸激酶ＭＢ同工酶（ＣＫ－ＭＢ）的变化，以评价经皮冠状动脉腔内成形术对心肌的可能影响。方法：对５９例行经皮冠状动脉腔内成形术的冠心病患者，分别测定其术前，术后６、１２、２４、４８和７２小时的血清ｃＴｎＩ及ＣＫ－ＭＢ水平，并进行分组比较。结果：１８例患者术前血清ｃＴｎＩ正常，术后６小时升高，１２～２４小时达峰值，４８～７２小时渐降至正常；３１例患者术前、术后血清ｃＴｎＩ均正常；１０例患者术前、术后血清ｃＴｎＩ均高于正常值。全部病例中仅３例患者ＣＫ－ＭＢ增高。血清ｃＴｎＩ升高与球囊扩张总时间及扩张次数有关。结论：经皮冠状动脉腔内成形术可能会造成心肌微小损伤，ｃＴｎＩ为监测心肌损伤的可靠而灵敏指标。

Objective:Serum cardiac troponin I(cTnI) and creatine kinase MB(CK MB) levels were monitored before and after percutaneous transluminal coronary angioplasty(PTCA) to evaluate the possible effect of PTCA on myocardium. Methods:Serum cTnI and CK MB were measured in 59 patients with coronary artery disease(CAD)undergoing PTCA before and at 6 th,12 th,24 th,48 th,72 nd hour after the procedure respectively. Results:The serum cTnI levels of 18 cases began to increase at 6 hours,reached the peak levels at 12 24 hours and returned to normal levels during 48 72 hours after PTCA.The serum cTnI levels of 31 cases remained normal range,but ones of 10 cases were over baseline levels before and after the procedure,while CK MB levels of 3 cases were over normal range for those patients.Compared with normal cTnI group,elevated cTnI was related to total inflation time and dilatation times. Conclusion:PTCA may cause some minor damage of myocardium,cTnI serum levels was more sensitive and specific for detecting myocardial injury.