目的观察和分析冠心病患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗围手术期不同类别操作血管的特点及心肌肌钙蛋白I(cardiac troponin I,cTnI)升高的相关因素。方法收集2014年3月~2015年11月,择期行PCI术的156例冠心病患者,根据操作血管分为前降支组(74例)、回旋支组(29例)和右冠脉组(53例),均为单支血管操作。根据术后cTnI变化情况将前降支组分为cTnI升高组(44例)和cTnI无变化组(30例)。所有患者均检测术前及术后3 h的cTnI,记录患者的各项基本资料、手术操作及术前血脂、血糖、肾功、离子等生化指标。结果前降支组术后cTnI较术前显著升高(P<0.01),回旋支组及右冠脉组术后cTnI较术前无显著变化。3组间支架:总长度、平均直径、总释放压力、总释放时间;球囊:扩张次数、总释放压力、总释放时间、单次扩张最大压力、是否后扩张;手术时间差异有统计学意义(P<0.05)。cTnI升高组术前低密度脂蛋白胆固醇(LDL-C)、C反应蛋白(CRP)高水平所占百分比及球囊单次扩张最长时间明显高于无变化组(P<0.05)。结论 1前降支病变患者PCI术后早期血清cTnI水平较术前明显升高;2术前LDL-C高水平、CRP高水平、球囊单次扩张最长时间可能为PCI术后早期cTnI升高的危险因素。 Objective To observe and analyze the characteristics of perioperative vascular changes and the related factors of cardiac troponin I (cTnI) in percutaneous coronary intervention (PCI) in patients with coronary heart disease. Methods From March 2014 to November 2015, 156 patients with coronary artery disease undergoing elective PCI were enrolled. According to the operating vessels, they were divided into anterior descending branch group (74 cases), circumflex branch group (29 cases) and right coronary artery group 53 cases), are single vessel operation. According to the change of postoperative cTnI, the anterior descending coronary artery was divided into cTnI elevation group (44 cases) and cTnI unchanged group (30 cases). All patients were detected before and 3 h after cTnI, the basic information recorded in patients with surgery and preoperative blood lipids, blood glucose, renal function, plasma and other biochemical indicators. Results The cTnI in the anterior descending coronary artery group was significantly higher than that before the operation (P <0.01). The cTnI in the circumflex artery group and the right coronary artery group did not change significantly after operation. The total length, average diameter, total release pressure, total release time; balloon: the number of expansion, the total release pressure, the total release time, the maximum single expansion pressure, whether the postoperative expansion; the difference was statistically significant (P <0.05). The percentage of preoperative low density lipoprotein cholesterol (LDL-C) and C-reactive protein (CRP), and the longest duration of single balloon dilatation in cTnI elevation group were significantly higher than those in non-change group (P <0.05). CONCLUSIONS: The level of serum cTnI in patients with DLD is significantly higher than that before operation. The high level of LDL-C, the high level of CRP and the longest duration of single balloon dilatation may be the pre-cTnI rise High risk factor.