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目的通过检测经皮冠状动脉介入治疗(PCI)术前后血清缺血修饰蛋白(IMA)、超敏C反应蛋白(hs-CRP)及肌钙蛋白(cTNI)的浓度变化,分析可能造成心肌缺血及损伤的原因。方法 92例接受PCI治疗的患者在PCI术前及术后30min,2h,6h,24h抽取静脉血检测IMA、hs-CRP、cTNI,同时对手术中球囊扩张时间、扩张次数、扩张平均压力等因素进行分析。结果术后IMA升高者占63.04%(58/92)、hs-CRP升高占50%(46/92),IMA在术后30min即有明显升高,与术前相比差异有统计学意义(P﹤0.01),峰值出现在术后2h,与术前相比差异有统计学意义(P﹤0.001),hs-CRP峰值出现在术后24 h,与术前相比差异有统计学意义(P﹤0.001)。cTNI术前术后差异无统计学意义(P﹥0.05)。IMA、hs-CRP与球囊扩张时间、扩张次数、扩张平均压力密切相关(P﹤0.05)。结论虽然PCI术对患者造成的心肌缺血及损伤是轻微和短暂的,但PCI术中仍应避免不必要的球囊扩张,尽量减少球囊扩张时间及压力以减少心肌缺血及损伤的发生。
Objective To investigate the changes of plasma concentrations of serum ischemic-modified protein (IMA), high-sensitivity C-reactive protein (hs-CRP) and troponin (cTNI) before and after percutaneous coronary intervention (PCI) Blood and injury causes. Methods 92 patients undergoing PCI were enrolled in this study. Serum samples of IMA, hs-CRP and cTNI were collected before PCI and at 30min, 2h, 6h and 24h after PCI. Meanwhile, the duration of balloon dilatation, the number of dilatation and the mean pressure of dilation Factors for analysis. Results Postoperative IMA increased in 63.04% (58/92), hs-CRP increased 50% (46/92), IMA at 30min after surgery was significantly increased, compared with the preoperative difference was statistically significant (P <0.01). The peak value appeared at 2h postoperatively, which was significantly different from that before operation (P <0.001). The peak value of hs-CRP appeared at 24 h postoperatively, which was statistically different from preoperative Significance (P <0.001). The difference of cTNI before and after surgery was not statistically significant (P> 0.05). IMA, hs-CRP and balloon dilation time, the number of dilation, the average pressure is closely related to expansion (P <0.05). Conclusions Although myocardial ischemia and injury caused by PCI are mild and transient, unnecessary balloon dilatation should be avoided during PCI to minimize the time and pressure of balloon dilatation in order to reduce the occurrence of myocardial ischemia and injury .