cTnI增高而CKMB正常冠心病患者冠状动脉病变的观察

Coronary Angiographic Characteristics in The Coronary Heart Disease Patients with Elevated Levels of Cardiac Troponin Ⅰ and Normal Levels of CKMB

目的观察心肌肌钙蛋白Ⅰ(cTnI)增高、肌酸激酶同工酶(CKMB)正常的冠心病患者中冠状动脉(冠脉)的病变程度及分布,探讨cTnI增高而CKMB正常对冠脉病变的临床预测价值。方法总共纳入139名患者,根据cTnI和CKMB水平分为4组,入选16例cTnI增高而CKMB正常者(A组)为研究组,同时25例cTnI增高而CKMB增高者(B组)和9例cTnI正常而CK-MB增高者(C组)及89例cTnI正常CKMB正常者(D组)为对照组。结果在冠脉病变程度上,A组与D组比较有统计学意义(P<0.05),而A组与B组及C组比较无统计学意义(P>0.05)。在冠脉病变范围上A组、B组、C组、D组间比较差异无统计学意义,χ2=6.3883,P=0.0942。结论血清cTnI水平与冠状动脉狭窄程度有相关性。cTnl水平越高,冠脉狭窄越重,冠状动脉病变越复杂。cTnI水平增高而CKMB正常者,存在严重的冠脉狭窄,狭窄程度与cTnI呈正相关,亦有闭塞病变存在。

Objective To observe the coronary angiographic characteristics in the coronary heart disease patients with elevated levels of cardiac troponin Ⅰ and normal levels of CKM, and to explore the predictive values of troponin Ⅰ - positive, CK - MB - negative in coro- nary heart disease. Methods A total of 139 patients were assigned into the four groups according to the levels of cardiac troponin Ⅰ and CKMB. There were 16 patients with elevated levels of cTnⅠ and normal levels of CKMB in group A, 25 patients with elevated levels of CK- MB and cTnⅠ in group B, 9 patients with normal levels of cTnl and elevated levels of CKMB in group C, and 89 patients with normal levels of cTnⅠ and CKMB in group D. Results The coronary artery lesions were more significant in group A than those in group D （ P 〈 0.05 ） , while there were no difference in coronary artery lesions among group A, group B and group C （ P 〉 0.05 ）. There was no difference in the numbers of diseased vessel among group A, group B, group C, and group D （χ2 = 6. 388,P = 0. 094）. Conclusion Serum cTnⅠ level was associated with the severity of coronary artery stenosis. There were more sever lesions, even occluded lesions in coronary artery pa- tients with elevated levels of cTnⅠ and CK - MB - negative. The degree of stenosis was positively related with levels of cTnⅠ.