冠状动脉介入治疗后血清心肌酶谱升高对预后的影响

Myocardial enzyme elevation after coronary intervention correlates with clinical prognosis

目的 观察冠状动脉介入治疗后血清心肌酶谱升高的影响因素及其对患者近、中期预后的影响。方法 对 5 6 9例冠心病患者行介入治疗后每间隔 6h查肌酸激酶 (CK)及其同工酶 (CK MB) ,肌钙蛋白I(cTnI)。结果 5 6 9例患者入组 ,其中CK、CK MB及CTnI均升高者 39例 ( 7%) ,酶谱升高的患者中除 3例 ( 1例急性心肌梗死 ,2例心包填塞 )外 ,其余患者心肌酶升高幅度均低于正常值两倍。在PTCA +支架组与单纯PTCA组 ,B、C型病变组与A型病变组 ,多支血管病变组与单支血管病变组以及心绞痛组与心肌梗死组比较 ,发现前组心肌酶谱明显升高 (P <0 0 5 )。在住院期间和随诊( 15± 7)个月心肌酶谱升高组患者心脏事件明显多于正常组。结论 冠状动脉介入治疗可致心肌酶谱升高 ,升高组患者近、中期心脏事件明显增加。

Objectives To evaluate the changes and risk factors of cardiac enzymes after successful coronary intervention, and to assess the influence on in-hospital course and midterm prognosis. Methods The levels of creatine kinase,its isoenzyme and troponin-I were detected every 6 hours for 24 hours after coronary interventional therapies in 569 patients. Results During the period of following-up (15±7)months, the levels of cardiac enzymes elevated in 39 among 569 patients, the ranges of which were less double times of normal value except in 3 patients. There were remarkable differences between PTCA group to PTCA+STENT group, type A lesion group to type B,C lesions group, single vessel group to multi-vessels group and pectoris angina to prior MI group (P<0.05). Patients with elevation of myocardial enzymes had more cardiac events than other patients during in-hospital and follow-up period. Conclusions Coronary interventional therapies could cause elevation of cardiac enzymes. The patients with elevation of cardial enzymes had more cardiac events in in-hospital and midtermperiod.