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目的:探讨经皮冠状动脉介入治疗术(PCI)后肌钙蛋白(cTnT)升高的预测因素。方法:80例行PCI的患者,按照术后cTnT水平分为2组:第1组:术后cTnT超过正常值2倍;第2组:术后cTnT水平低于正常值2倍。以血管内超声虚拟组织成像检测冠状动脉斑块各种成分的比例,并测定血小板聚集率。结果:第1组患者不稳定斑块数量较多,斑块中坏死核心比例[(20.88±8.04)%∶(15.31±5.48)%,P<0.05]、血小板聚集率[(51.47±12.72)%∶(44.78±13.29)%,P<0.05]、所置入支架长度均显著大于第2组。PCI术后24h血清cTnT水平与冠状动脉斑块中坏死成分比例呈显著正相关。结论:PCI术后cTnT升高的预测因素有斑块中坏死成分比例、血小板聚集率和所植入支架长度。
Objective: To investigate the predictors of elevated troponin (cTnT) after percutaneous coronary intervention (PCI). Methods: Eighty patients undergoing PCI were divided into two groups according to the level of postoperative cTnT: group 1: cTnT exceeded 2 times of normal; group 2: cTnT level was 2 times lower than normal. The proportion of various components of coronary plaque was detected by intravascular ultrasound virtual tissue imaging and platelet aggregation rate was measured. Results: The number of unstable plaque in group 1 was higher than that in group 1 ([(20.88 ± 8.04)% vs (15.31 ± 5.48)%, P <0.05] and platelet aggregation rate (51.47 ± 12.72% : (44.78 ± 13.29)%, P <0.05]. The length of stent was significantly larger than that of the second group. The level of cTnT in serum was positively correlated with the proportion of necrotic components in coronary plaque at 24 hours after PCI. CONCLUSION: The predictors of elevated cTnT after PCI are the proportion of necrotic components in the plaque, the platelet aggregation rate, and the length of the stent implanted.