CAJ | 학술논문

目的：探讨入院时肌钙蛋白-I(cTnI)阴性的急性冠脉综合征(ACS)患者在择期行经皮冠状动脉介入治疗(PCI)后血浆cTnI水平变化及其与冠脉病变、介入操作及预后的关系。方法：选取择期行PCI的ACS患者106例，术前和术后24 h测定血浆cTnI水平，记录手术操作中的各项指标，随访主要心脏不良事件(MACE)的发生情况。结果：不稳定型心绞痛(UAP)、糖尿病、分叉病变、多支病变、支架长度、球囊扩张总时间和总次数在cTnI升高组及正常组之间差异有统计学意义。将上述指标列入多元回归模型，分析显示球囊扩张总时间、UAP及糖尿病在两组间差异有统计学意义。cTnI升高组MACE发生较多。结论：①UAP、糖尿病、分叉病变、多支病变和球囊扩张总时间、总次数及支架长度等因素与PCI相关心肌损伤有关；②cTnI对ACS患者行PCI术后早中期发生MACE具有较好的预测价值。
목적：탐토입원시기개단백-I(cTnI)음성적급성관맥종합정(ACS)환자재택기행경피관상동맥개입치료(PCI)후혈장cTnI수평변화급기여관맥병변、개입조작급예후적관계。방법：선취택기행PCI적ACS환자106례，술전화술후24 h측정혈장cTnI수평，기록수술조작중적각항지표，수방주요심장불량사건(MACE)적발생정황。결과：불은정형심교통(UAP)、당뇨병、분차병변、다지병변、지가장도、구낭확장총시간화총차수재cTnI승고조급정상조지간차이유통계학의의。장상술지표렬입다원회귀모형，분석현시구낭확장총시간、UAP급당뇨병재량조간차이유통계학의의。cTnI승고조MACE발생교다。결론：①UAP、당뇨병、분차병변、다지병변화구낭확장총시간、총차수급지가장도등인소여PCI상관심기손상유관；②cTnI대ACS환자행PCI술후조중기발생MACE구유교호적예측개치。
Objective:To discusses the changes of plasma cTnI levels and its relationship with coronary artery disease, interventional operation, the prognosis in acute coronary syndrome patients with cTnI-negative in elective percutaneous coronary intervention after treatment. Methods:We select clinical data about 106 cases of elective PCI treatment of patients, determine plasma cTnI levels in preoperative and postoperative 24 hours, record the index about operative and follow up major adverse cardiac events occurrence. Results:Unstable angina pectoris, diabetes mellitus, bifurcation lesions, multivessel disease, stent length , the total number and total time of balloon dilatation have statistically significance between the elevated group and the normal group of cTnI. With the seven indicators included in the multiple regression models shows that the total time of balloon angioplasty, unstable angina, diabetes difference between the two groups has statistical significance. After PCI, cTnI elevated group of patients with MACE occurred are more. Conclusion: 1.The factors of UAP, DM, bifurcation lesions, multivessel disease, balloon total time and total number of stent length are associated with PCI myocardial injury related;2. The detection of cTnI has predictive value of MACE in ACS patients early and mid-term.