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目的本研究比较了择期PCI手术患者术前和术后高敏感(hs-cTnⅠ)和普通敏感(con-cTnⅠ)心肌肌钙蛋白I的浓度变化差异。方法随机选取32例择期PCI手术患者,分别在术前和术后24小时采集血样,分离血清后,用雅培和贝克曼-库尔特两种化学发光方法同时检测。结果 PCI术后患者hs-cTnⅠ均值从0.013ng/ml升高到0.091ng/ml,高于99th百分位参考上限3倍,con-cTnⅠ均值从0.009ng/ml升高到0.061ng/ml,高于99th百分位参考上限1.5倍。术后的cTnⅠ浓度变化与术前的基线浓度相关性均很弱,且con-cTnⅠ较hs-cTnⅠ的相关性更弱(r=0.39 vs 0.42)。术前和术后的hs-cTnⅠ绝对浓度变化为0.081ng/ml(95%CI:0.036-0.125),con-cTnⅠ绝对浓度变化为0.056ng/ml(95%CI:0.027-0.084),二者具有显著差异(p=0.01)。hs-cTnⅠ在术后升高5和10倍的比例明显高于con-cTnⅠ的升高比例。随着hs-cTnⅠ变化幅度的增大(从>50%至>200%)住院天数逐渐延长,而con-cTnⅠ的浓度变化与住院天数的关联性并不明显。结论 hs-cTnⅠ在择期PCI手术前后的浓度变化幅度高于con-cTnⅠ,更有助于监测PCI相关的心肌梗死发生。
Objectives This study compared differences in cardiac troponin I concentrations between preoperative and postoperative hypersensitivity (hs-cTnI) and normal-sensitive (con-cTnI) myocardium in patients undergoing elective PCI. Methods Thirty - two patients undergoing elective PCI were selected randomly. Blood samples were taken before and 24 hours after operation. Serum was separated and detected by two chemiluminescence methods, Abbott and Beckman Coulter. Results The mean hs-cTnI in patients with PCI increased from 0.013ng / ml to 0.091ng / ml, higher than the upper limit of 99th percentile by 3 times, and the average value of con-cTnI increased from 0.009ng / ml to 0.061ng / ml, Higher than the 99th percentile reference limit of 1.5 times. The correlation between postoperative cTnI concentration and preoperative baseline concentration was weak, and the correlation between con-cTnI and hs-cTnI was weaker (r = 0.39 vs 0.42). The absolute concentration of hs-cTnI before and after surgery was 0.081 ng / ml (95% CI: 0.036-0.125) and the absolute con-cTnI concentration was 0.056 ng / ml (95% CI: 0.027-0.084) There was a significant difference (p = 0.01). The ratio of hs-cTnI increased 5 and 10 times after operation was significantly higher than that of con-cTnI. As the hs-cTnI amplitude increased (from> 50% to> 200%), the days of hospitalization gradually increased, but the con-cTnI concentration was not correlated with the length of hospital stay. Conclusions The change of hs-cTn Ⅰ concentration before and after elective PCI is higher than that of con-cTn Ⅰ, and it is more helpful to monitor the incidence of PCI-related myocardial infarction.