老年冠状动脉梗阻患者急诊PCI后血清炎症因子水平和心肌损伤指标值变化及临床意义

Changes of serum inflammatory factor levels and myocardial injury index values in elderly patients with coronary artery obstruc⁃tion after emergency PCI and their clinical significance

目的 分析老年冠状动脉梗阻患者急诊经皮冠状动脉介入治疗(PCI)术前后血清炎症指标、心肌损伤指标变化情况及临床意义,为治疗该病症提供临床分析。方法 回顾性分析2020年1月—2021年12月达州市中心医院住院部诊治的120例老年冠状动脉梗阻患者(设为观察组)和同期性别和年龄等匹配的健康体检的35名志愿者(设为对照组)的资料,比较2组血清炎症反应指标值[白介素-10(IL-10)、高敏C反应蛋白(hsCRP)]、心肌损伤指标值[血清肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)],并进行相关性分析。结果 观察组患者的血清IL-10水平较对照组明显降低(P<0.05),血清hsCRP、 CK-MB、 cTnI水平较对照组明显升高(P<0.05);观察组术后血清IL-10水平较术前明显升高(P<0.05),而血清hsCRP、 CK-MB、 cTnI水平明显降低(P<0.05)。左侧老年冠状动脉梗阻患者血清IL-10水平较右侧组略低,hsCRP、 CK-MB、 cTnI较右侧略高,差异均无统计学意义(P>0.05)。随老年冠状动脉梗阻患者病变程度增加,血清IL-10明显降低(P<0.01),而血清hsCRP、 CK-MB、 cTnI明显增高(P<0.01)。老年冠状动脉梗阻患者急诊PCI术前血清IL-10水平与CK-MB、 cTnI呈明显负相关(P<0.001),而血清hsCRP水平与CK-MB、 cTnI水平呈明显正相关(P<0.001)。结论 老年冠状动脉梗阻患者急诊PCI术后血清炎症指标值、心肌损伤指标值较术前存在明显的差异,炎症指标值、心肌损伤指标值可能与患者病变部位无关,但可能与患者冠脉病变程度相关,且血清炎症指标值与心肌损伤指标值存在明显相关性。

Objective To analyze the changes of serum inflammatory indexes and myocardial injury indexes before and after emergency percutaneous coronary intervention(PCI)in elderly patients with coronary artery obstruction and their clinical significance,so as to provide clinical analysis for the treatment of this disease.Methods The data of 120 elderly patients(set as the observation group)with coronary artery obstruction diagnosed and treated in Inpatient Department of Central Hospital of Dazhou City from January 2020 to December 2021 and 35 healthy volunteers(set as the control group)who received physical examination and matched in gender and age during the same period were retrospectively analyzed.The levels of serum inflam⁃matory response indexes[interleukin⁃10(IL⁃10),high⁃sensitive C⁃reactive protein(hs⁃CRP)],myocardial injury indexes[serum creatine kinase isoenzyme(CK⁃MB),troponin I(cTnI)]were detected and compared between the two groups.Then correlation analysis was performed.Results The level of serum IL⁃10 of the observation group was significantly lower than that of the control group,and the levels of hs⁃CRP,CK⁃MB and cTnI were significantly higher than those of the control group(P<0.05).After surgery,the level of serum IL⁃10 increased significantly and the levels of hs⁃CRP,CK⁃MB and cTnI de⁃creased significantly in the observation group(P<0.05).The level of serum IL⁃10 of the left coronary artery obstruction group were slightly lower than those of the right coronary artery obstruction group,while the levels of hs⁃CRP,CK⁃MB and cTnI were slightly higher than those of the right coronary artery obstruction group,but the differences were not statistically sig⁃nificant(P>0.05).With the increase of the lesion degree of coronary artery obstruction,the level of serum IL⁃10 decreased significantly(P<0.01),while levels of hs⁃CRP,CK⁃MB and cTnI increased significantly(P<0.01).The level of serum IL⁃10 before emergency PCI in elderly patients with coronary artery obstruction was significantly negatively correlated with the levels of CK⁃MB and cTnI(P<0.001),while the level of serum hs⁃CRP was significantly positively correlated with the levels of CK⁃MB and cTnI(P<0.001).Conclusion The levels of serum inflammatory indexes and myocardial injury indexes after emergency PCI in elderly patients with coronary artery obstruction are significantly different from those before surgery.The lev⁃els of serum inflammatory indexes and myocardial injury indexes may not be related to the lesion site,but may be related to the degree of coronary artery lesions,and there is a significant correlation between the two.