缺血预适应对PTCA术后心肌肌钙蛋白I升高的影响

Beneficial impact of preconditioning during PTCA on cardiac troponin I release

目的 用血清心肌肌钙蛋白I(cTnI)作为心肌损伤标记物评价缺血预适应 (IP)对经皮腔内冠状动脉成形术 (PTCA)心肌损伤的保护作用。方法 把 15 0例行PTCA的冠心病 (CAD)患者随机分为两组 :(1)常规手术组 (UC组 ) 12 0例 ;(2 )缺血预适应组 (设置缺血预适应手术方式 ,IP组 ) 30例。两组分别测定其术前、术后第 6、12、2 4、4 8、72小时的血清cTnI水平并进行随访 ,分析相关因素 ,比较两组间cTnI的变化及出院后发生的心脏事件。结果 UC组 12 0例患者中 2 9例术后cTnI升高 ,IP组 30例患者中 2例术后cTnI升高 ,两组cTnI升高差异有显著性 (P <0 0 5 ) ;随访发现发生的心脏事件两组间差异无显著性 (P >0 0 5 )。结论 缺血预适应对PTCA术造成的心肌损伤有保护作用 ,现尚不能肯定IP对PTCA术后患者心脏事件有影响。

Objective To evaluate protective function of ischemia preconditioning for myocardium during percutaneous transluminal coronary angioplasty (PTCA), using cardiac troponin I (cTnI) as myocardial injury marker. Methods One hundred and fifty patients with coronary artery disease (CAD) undergoing PTCA were divided into two groups: Group Usual Cure (G-UC), including 120 cases, and Group Ischemia Precondition (G-IP), including 30 cases. Serum cTnI were measured before and 6, 12, 24, 48 and 72 hours after the procedure respectively. The relative factors were analyzed. The cardiac events were followed-up.Results The serum cTnI levels of 29 cases elevated in G-UC, while those of 2 cases elevated in G-IP. There was statistical difference on elevated cTnI levels between the two groups (P<0.05). In the follow-up, occurrence of cardiac events was not statistically different in the two groups. Conclusion Ischemia preconditioning may protect myocardium dueing PTCA. Now it can not be sured that IP has impact on cardiac events in cases after PTCA.