中国急救复苏与灾害医学杂志
中國急救複囌與災害醫學雜誌
중국급구복소여재해의학잡지
CHINA JOURNAL OF EMERGENCY RESUSCITATION AND DISASTER MEDICINE
2015年
2期
122-124,127
,共4页
刘利峰%赵蓓%时全星%刘莉%赵京涛%刘瑛琪%彭佑华%宋洪勇%毛帅%周莉%夏会会%高铁山%王守力
劉利峰%趙蓓%時全星%劉莉%趙京濤%劉瑛琪%彭祐華%宋洪勇%毛帥%週莉%夏會會%高鐵山%王守力
류리봉%조배%시전성%류리%조경도%류영기%팽우화%송홍용%모수%주리%하회회%고철산%왕수력
经皮冠状动脉介入治疗%肌钙蛋白%PCI相关心肌梗死
經皮冠狀動脈介入治療%肌鈣蛋白%PCI相關心肌梗死
경피관상동맥개입치료%기개단백%PCI상관심기경사
Percutaneous coronary intervention%Troponin%PCI-related myocardial infarction
目的：探讨择期经皮冠状动脉介入治疗（PCI）术后肌钙蛋白I（cTnI）升高在PCI相关心肌损伤、心肌梗死诊断中的地位及对临床的指导意义。方法择期 PCI 的住院冠心病患者386例，平均年龄（61.84±9.94）岁，男297例（76.94%），女89例（23.06%），按照是否满足2012年心肌梗死通用定义专家共识分组为PCI相关心肌损伤（梗死）组（104例）和对照组（282例）。术前和术后24 h和48 h分别抽取外周静脉血用化学发光法检测 cTnI 水平。比较两组患者伴随疾病、术中支架数目、支架总长度、住院天数、住院总费用。结果 cTnI升高标准者（心肌损伤组）104例（发生比率为26.94%），同时能明确诊断PCI相关心肌梗死者23例（发生比率为5.96%）。心肌损伤组与对照组在年龄、住院总天数方面的差异无统计学意义（均P >0.05）。术后cTnI-术前cTnI≥0者303例。PCI术后cTnI升高程度与植入支架的总长度及总住院费用均呈线性正相关（分别为r=0.123，P =0.036；r=0.131，P =0.023）。PCI相关心肌损伤（包括PCI相关心肌梗死）组植入的支架数量及支架总长度、单次住院费用、合并高血压比率均显著高于对照组（均P <0.05）；合并糖尿病比率（37.50%）也高于对照组（29.43%），但差异无统计学意义（P =0.083）。结论 PCI术后肌钙蛋白I（cTnI）升高具有重要临床意义，其升高程度与心肌损伤程度有关。常规检测肌钙蛋白是必要的。
目的：探討擇期經皮冠狀動脈介入治療（PCI）術後肌鈣蛋白I（cTnI）升高在PCI相關心肌損傷、心肌梗死診斷中的地位及對臨床的指導意義。方法擇期 PCI 的住院冠心病患者386例，平均年齡（61.84±9.94）歲，男297例（76.94%），女89例（23.06%），按照是否滿足2012年心肌梗死通用定義專傢共識分組為PCI相關心肌損傷（梗死）組（104例）和對照組（282例）。術前和術後24 h和48 h分彆抽取外週靜脈血用化學髮光法檢測 cTnI 水平。比較兩組患者伴隨疾病、術中支架數目、支架總長度、住院天數、住院總費用。結果 cTnI升高標準者（心肌損傷組）104例（髮生比率為26.94%），同時能明確診斷PCI相關心肌梗死者23例（髮生比率為5.96%）。心肌損傷組與對照組在年齡、住院總天數方麵的差異無統計學意義（均P >0.05）。術後cTnI-術前cTnI≥0者303例。PCI術後cTnI升高程度與植入支架的總長度及總住院費用均呈線性正相關（分彆為r=0.123，P =0.036；r=0.131，P =0.023）。PCI相關心肌損傷（包括PCI相關心肌梗死）組植入的支架數量及支架總長度、單次住院費用、閤併高血壓比率均顯著高于對照組（均P <0.05）；閤併糖尿病比率（37.50%）也高于對照組（29.43%），但差異無統計學意義（P =0.083）。結論 PCI術後肌鈣蛋白I（cTnI）升高具有重要臨床意義，其升高程度與心肌損傷程度有關。常規檢測肌鈣蛋白是必要的。
목적：탐토택기경피관상동맥개입치료（PCI）술후기개단백I（cTnI）승고재PCI상관심기손상、심기경사진단중적지위급대림상적지도의의。방법택기 PCI 적주원관심병환자386례，평균년령（61.84±9.94）세，남297례（76.94%），녀89례（23.06%），안조시부만족2012년심기경사통용정의전가공식분조위PCI상관심기손상（경사）조（104례）화대조조（282례）。술전화술후24 h화48 h분별추취외주정맥혈용화학발광법검측 cTnI 수평。비교량조환자반수질병、술중지가수목、지가총장도、주원천수、주원총비용。결과 cTnI승고표준자（심기손상조）104례（발생비솔위26.94%），동시능명학진단PCI상관심기경사자23례（발생비솔위5.96%）。심기손상조여대조조재년령、주원총천수방면적차이무통계학의의（균P >0.05）。술후cTnI-술전cTnI≥0자303례。PCI술후cTnI승고정도여식입지가적총장도급총주원비용균정선성정상관（분별위r=0.123，P =0.036；r=0.131，P =0.023）。PCI상관심기손상（포괄PCI상관심기경사）조식입적지가수량급지가총장도、단차주원비용、합병고혈압비솔균현저고우대조조（균P <0.05）；합병당뇨병비솔（37.50%）야고우대조조（29.43%），단차이무통계학의의（P =0.083）。결론 PCI술후기개단백I（cTnI）승고구유중요림상의의，기승고정도여심기손상정도유관。상규검측기개단백시필요적。
Objective To investigate the clinical instructive significance of troponin elevation (cTnl) after elective percutaneous coronary intervention (PCI). Methods A total of 386 hospitalized patients with coronary heart disease who underwent elective PCI, 297 males and 89 females, aged (61.84 ± 9.94), underwent collection of peripheral venous blood samples to examine the levels of cTnl by chemiluminescence method before PCI and 24hours and 48hours after PCI. Then they were divided into 2 groups based on the cTnl levels of the 2012 Expert Consensus Document on the Third Universal Definition of Myocardial Infarction: PCI-related myocardial injury (including infarction) group and control group. In addition, the incidence of concomitant diseases, the number of intraoperative stents, overall length of stents, hospitalization days and the total cost in hospital were compared. Results According to the cTnl levels 104 patients were included into the PCI-related myocardial damage group and 282 patients were in the control group. The incidence of PCI-related myocardial infarction was 5.96% . No significant differences in the age and hospitalization days were found between the two groups. The degree of cTnI elevation was positively correlated with the overall length of stents and the total hospitalization cost. The number of intraoperative stents, overall length of stents, total cost of single hospital admission, and incidence of hypertension of the PCI-related myocardial injury (infarction) group were all significantly higher than those of the control group (all P <0.05). The incidence of diabetes of the PCI-related myocardial injury (infarction) group was 37.50%, but not significantly higher than that of the control group (29.43% , P=0.083).Conclusion Correlated with myocardial damage, the elevation of troponin after elective PCI is of important significance in clinical application. And the routine detection of cTnI is necessary.
