摘要
目的探讨经皮腔内冠状动脉成形术(PTCA)是否对慢性冠状动脉供血不足产生缺血及再灌注损伤。方法 选择行PTCA的慢性冠心病患者18例为观察组(PTCA组),怀疑有冠心病行选择性冠状动脉造影(SCA)患者20例作对照组(SCA组),观察血清心肌酶CK-MB、LDH、外周血白细胞计数(WBC)及中性粒细胞百分比(PMN%)在手术前后的变化。结果 所有PTCA均成功,术后残余狭窄均小于15%。手术后上述指标与术前相比两组均有明显升高(P<0.05),但术后两组间比较,尽管PTCA组CK-MB、WBC、PMN%较对照组有升高趋势,但无统计学差异(P>0.05)。结论 PTCA对慢性冠状动脉供血不足不产生显著的缺血及再灌注损伤,但不能排除轻微的损伤作用,这种损伤不仅与PTCA中球囊扩张的时间,球囊的压力及基础病变有关,还与心肌组织的病理生理状态有关,对不稳定性心绞痛病人PTCA可能增加缺血及再灌注损伤的机会和程度。
Objective In order to study whether PTCA aggrevates myocardial ischemia and induces reperfusion injury or not Methods : 8 cases of coronary heart disease (CAD) were selected for pereutanous coronary angioplast (PTCA) as PTCA group; 20 cases were suspects of coronary heart disease for selective coronary angiography (SCA) as SCA group. Serum myocardiac enzyme CK-MB.LDH and peripheral WBC were observed before and after operation (PTCA and SCA). Results All PTCA were successfully performed, all residual stenoses were less than 15%. All indices of two groups were higher after operation than that before (p < 0.05). but there were not significantly statistical differences between two groups after operation(P > 0. 05) Conclusions PTCA neither aggrevates seriously myocardial ischemia nor induce obvious reperfusion injury. But it does not deny mild injury effect on PTCA. ms mild injury is related to at only inflation for, pressure and basic pathomorphology but also pathophysiologic state of myocardium. PICA for unstable angia pectoris probably increase the chance and the degree of myocardial ischemia and reperfusion injury.
出处
《洛阳医专学报》
1999年第1期8-10,共3页
Journal of Luoyang Medical College
基金
湖北省科委九五攻关课题
关键词
冠状动脉成形
冠心病
白细胞
心肌缺血
PTCA
ischemia and reprfusion injury
coronary heart disease
WBC
CK-MB