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目的 观察冠心病介入治疗前后心肌损伤标记物的变化。方法 将研究对象分成 2组。介入组 2 6例 ;3 0例同期进行冠状动脉造影的患者作为对照组。均于术前及术后 16h测定CK -MB和cTnI血清浓度。结果 介入组cTnI术前为 1 0 1±0 63ng/ml,术后为 1 75± 1 73ng/ml,前后比较有显著差异 (P <0 0 5 ) ;CK -MB在手术前、后分别为 ( 14 2 7± 5 )U/L、( 15 92± 9 18)U/L ,前后比较无显著差异 (P >0 0 5 )。对照组cTnI在造影前、后分别为 ( 0 8± 0 16)ng/ml、( 0 87± 0 2 6)ng/ml,前后比较无显著差异 (P >0 0 5 ) ;造影前、后CK -MB分别为 ( 13 5 3± 6 68)U/L、( 14 2 7± 7 3 6)U/L ,前后比较无显著差异 (P >0 0 5 )。在介入组内 ,cTnI升高者球囊扩张时间、最大扩张压力、置入支架数与cTnI未升高者比较无显著差异 ( P >0 0 5 )。治疗中 2例发生侧支闭塞 ,这2例cTnI明显升高。结论 介入治疗可致部分患者心肌微损伤 ,其原因与侧支闭塞并发症有关 ,本文未发现支架置入数、球囊扩张时间等因素与心肌微损伤之间的关系
Objective To observe the changes of myocardial injury markers before and after interventional therapy of coronary heart disease. Methods The subjects were divided into two groups. There were 26 cases in the intervention group and 30 cases of coronary angiography in the same period as the control group. The serum concentrations of CK-MB and cTnI were measured before and 16 h after operation. Results The mean preoperative cTnI in the intervention group was 1 0 1 ± 0 63ng / ml and postoperatively 1 75 ± 1 73ng / ml, with significant difference before and after the intervention (P <0 05). CK-MB was (14 2 7 ± 5) U / L, (15 92 ± 9 18) U / L, no significant difference between before and after (P> 0.05). The levels of cTnI in the control group before and after angiography were (0 8 ± 0 16) ng / ml and (0 87 ± 0 2 6) ng / ml, respectively, with no significant difference between before and after angiography (P 0 05) CK-MB were (13 53 ± 6 68) U / L and (14 27 ± 7 36) U / L, respectively, with no significant difference between before and after treatment (P> 0.05). There was no significant difference in balloon dilation time, maximum dilatation pressure, number of stent placement and cTnI elevation in cTnI patients in the intervention group (P> 0.05). Two cases of lateral occlusion occured in treatment, and the cTnI in the two cases was significantly higher. Conclusions Interventional therapy may cause myocardial micro injury in some patients. The reason is related to the complications of collateral obstruction. The relationship between myocardial microinjury and other factors such as stent placement, balloon dilation time and other factors was not found