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目的观察不同类型冠状动脉病变介入治疗前后血液B型利钠肽(BNP)及心肌肌钙蛋白I(cTnI)的变化。方法选取接受冠状动脉介入治疗的患者52例,根据冠状动脉病变血管累及范围分为单支病变组、双支病变组,分别测定两组患者术前、术后6、24、48h BNP,cTnI水平,并记录术中球囊扩张时间、扩张次数、造影剂用量。结果单支病变组球囊扩张时间、扩张次数及造影剂用量均小于双支病变组(P<0.05);两组术后6h BNP水平均高于术前(P<0.05),术后24h达峰值;两组术后24h cTnI水平显著升高(P<0.05),但单支病变组BNP、cTnI峰值水平低于双支病变组(P<0.05)。结论多支病变或复杂病变患者介入治疗后BNP、cTnI水平升高明显,提示应进行术前危险评估,术后应给予适当药物辅助治疗改善预后。
Objective To observe the changes of blood B-type natriuretic peptide (BNP) and cardiac troponin I (cTnI) before and after the interventional treatment of different types of coronary lesions. Methods Fifty-two patients undergoing coronary intervention were divided into single vessel disease group and double vessel disease group according to the extent of vascular involvement of coronary artery disease. The levels of BNP and cTnI were measured at 6, 24 and 48 hours after operation in both groups , And recorded intraoperative balloon dilation time, the number of dilation, contrast agent dosage. Results The duration of balloon dilatation, the number of dilatation and the amount of contrast medium in single vessel lesion group were both less than those in double vessel lesion group (P <0.05). The BNP levels in both groups were significantly higher than those before operation (P <0.05) (P <0.05). However, the peak levels of BNP and cTnI in single vessel lesion group were lower than those in double vessel lesion group (P <0.05). Conclusions The levels of BNP and cTnI in patients with multi - vessel disease or complicated pathological changes are obviously elevated after interventional therapy, which suggests that preoperative risk assessment should be performed. Adjuvant therapy should be given to improve the prognosis after operation.