不稳定型心绞痛患者肌钙蛋白I与心电图ST段变化及冠脉造影的关系探讨

Relationship between the cardiac troponin I and ST segments changes in ECG and the narrowing characteristics of coronary artery in patients with unstable angina pectoris

目的 探讨不稳定型心绞痛 (UAP)患者肌钙蛋白 I(c Tn I)与心电图 ST段移位及冠状动脉病变性质之间的关系。方法 对 5 7例 U AP患者于心绞痛发作时 ,发作 6、2 4小时取静脉血 2 ml,用酶联免疫分析法测血清 c Tn I浓度 ,同时做 12～ 18导联心电图 ,计算 ST段缺血性下移或上移情况。5 7例患者按 Judkins法行冠状动脉造影术 ,按 2 0 0 1年 ACC/AHA PCI标准将冠状动脉解剖病变分低危险、中危险、高危险病变 ,按传统 Proudilit狭窄分级法将冠脉狭窄分为 ～ 级 ,分析 c Tn I与心电图 ST段移位及冠状动脉危险病变之间的关系。结果 UAP患者心绞痛发作后 6、2 4小时 c Tn I明显增高 ,且 2 4小时 c Tn I浓度与心电图 ST段移位相关 (r =0 .5 9,P<0 .0 5 ) ,病变愈复杂 (中、高危险病变 )狭窄程度愈重 (>5 0 %以上狭窄 ) ,c Tn I愈高。结论 c Tn I可预测 U AP患者的预后 ,c Tn I愈高 ,心电图 ST段移位愈大 。

Objective To investigate the relationship between the cardiac troponin I (cTnI) and ST segments changes in electrocardiogram(ECG) and the narrowing characteristics of coronary artery in patients with unstable angina pectoris(UAP).Methods The cTnI in venous blood and the ECG were measured when the angina occurred,6 hours and 24 hours later.The ST segments elevation or depression were calculated.57 patients had been done the angiography.According to the narrowing characteristic of the coronary artery,they were divided into 3 risk groups and 6 grades.Results Through the relative analysis,cTnI were raised significantly 6,24 hours after the angina occurred and cTnI in 24 hours was related with the ST segments changes.The more narrows the artery,the more risk the artery,the more high the concentration of the cTnI.Conclusion cTnI may be used to predict the prognosis of UAP patients.