不稳定性心绞痛经皮冠状动脉介入术后内脂素与肌钙蛋白Ⅰ变化及意义
Clinical significance of visfatin and cTnI in patients with unstable angina pcetoris after coronary stent implantation
目的 探讨不稳定性心绞痛(UAP)患者经皮冠状动脉介入治疗(PCI)前后血清内脂素(Visfatin)及肌钙蛋白Ⅰ(cardiac Troponin Ⅰ,cTnI)水平变化及临床意义.方法 选择108例UAP经PCI的患者,分别在术前,术后24、72 h及30 d测定血清Visfatin水平及cTnI水平.入选同期52例冠脉造影正常者作为对照组.随访3年,观察术后主要心脏不良事件(MACE)发生与Visfatin和cTnI水平之间的关系.结果 UAP患者Visfatin和cTnI水平PCI术后24h较术前明显升高(P=0.01);Visfatin水平在术后30 d与术前差异无统计学意义(P=0.12);cTnI水平在术后30 d显著低于术前水平(P=0.02);Visfatin与cTnI水平呈正相关(r=0.523,P=0.01);发生MACE的PCI患者术后血清Visfatin与cTnI水平明显高于未发生MACE患者(P=0.03);Visfatin与cTnI是MACE独立危险因素(OR=3.27,2.85,P<0.05).结论 UAP患者PCI术后血清Visfatin与cTnI水平均一过性升高,且与发生MACE相关,两者在UAP患者PCI术后发生MACE的预测方面均有一定价值.
更多Objective To investigate the changes and clinical significance of serum visfatin and cardiac troponin I (cTnI) level in patients with unstable angina pectoris (UAP) after percutaneous coronary intervention (PCI).Methods The 108 patients (aged 51 ~80 years) with UAP and 52 healthy subjects (aged 48 ~ 75) were enrolled.Before and after PCI at the different time,the serum levels of visfatin and cTnI were analyzed.During three years followed-up,the major adverse cardiac events (MACE) were assessed.MACE defined as cardiac death,myocardial infarction,target lesion revascularization anginal status.Results Twenty four hours later after PCI,compared with the level before PCI,the serum visfatin and cTnI levels of the UAP group were significantly increased (P =0.01) ; the serum Visfatin levels of the UAP group before PCI and 30 days later after PCI had no significant difference(P =0.12) ; Thirty days later after PCI,the serum cTnI levels of the UAP group were lower than them before PCI (P =0.02) ; high level visfatin and cTnI were independent predictors of MACE in UAP after PCI (OR =3.27,2.85) (P <0.05).The serum cTnI and visfatin levels were significantly positive correlation (r =0.523,P =0.01).Conclusions The serum visfatin and cTnI levels in patients with UAP after PCI increased transitorily,and they had certain value in predicting MACE.
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