Johansen O, Brekke M, Strømme J H, Valen V, Seljeflot I, Skjaeggestad O, Arnesen H
Department of Cardiology, Ullevål University Hospital, Oslo, Norway.
Eur Heart J. 1998 Jan;19(1):112-7. doi: 10.1053/euhj.1997.0732.
The present study was undertaken to assess the effect of balloon inflation during percutaneous transluminal coronary angioplasty on markers of myocardial damage.
Seventy-five patients undergoing elective percutaneous transluminal coronary angioplasty were evaluated with serum creatine kinase MB and cardiospecific troponin T before and 1 and 4 days after the procedure. On day 1, 28% of the patients had increased cardiospecific troponin T values and 18% had increased creatine kinase MB values. On day 4, 24% had increased cardiospecific troponin T values, whereas all creatine kinase MB values were normal. A high degree of correlation between creatine kinase MB and cardiospecific troponin T on day 1, as well as between both markers on day 1 and cardiospecific troponin T on day 4 were found. The increased levels of cardiospecific troponin T on day 4 was significantly correlated with the total balloon inflation time (P < 0.001).
We conclude that irreversible myocardial damage, as evidenced by increased cardiospecific troponin T values on day 4, occurs in an appreciable number of patients during percutaneous transluminal coronary angioplasty, and that this damage is strongly correlated with the total balloon inflation time.
本研究旨在评估经皮腔内冠状动脉成形术期间球囊扩张对心肌损伤标志物的影响。
对75例行择期经皮腔内冠状动脉成形术的患者在术前、术后1天和4天测定血清肌酸激酶MB和心肌特异性肌钙蛋白T。术后第1天，28%的患者心肌特异性肌钙蛋白T值升高，18%的患者肌酸激酶MB值升高。术后第4天，24%的患者心肌特异性肌钙蛋白T值升高，而所有肌酸激酶MB值均正常。发现术后第1天肌酸激酶MB与心肌特异性肌钙蛋白T之间、以及术后第1天这两种标志物与术后第4天心肌特异性肌钙蛋白T之间存在高度相关性。术后第4天心肌特异性肌钙蛋白T水平升高与球囊总扩张时间显著相关（P < 0.001）。
我们得出结论，在经皮腔内冠状动脉成形术期间，相当数量的患者出现了不可逆的心肌损伤，表现为术后第4天心肌特异性肌钙蛋白T值升高，且这种损伤与球囊总扩张时间密切相关。
