PCI對不穩(wěn)定型心絞痛患者血清肌鈣蛋白、超敏C反應(yīng)蛋白、白介素-6影響的研究
發(fā)布時間：2018-10-23 19:44
【摘要】：背景冠心病(CHD)是目前最常見、危害最大的心臟疾病,嚴(yán)重危害著人類健康,是威脅人們生命的重要疾病。不穩(wěn)定型心絞痛(UAP)是冠心病心絞痛的常見類型,是介于穩(wěn)定型心絞痛(SAP)和急性心肌梗死(AMI)之間。它是在冠狀動脈粥樣硬化病變的基礎(chǔ)上發(fā)生的,是急性冠脈綜合征(ACS)的常見類型。PCI是不穩(wěn)定型心絞痛常用的治療方法之一,但隨之出現(xiàn)部分患者PCI術(shù)后支架內(nèi)再狹窄的問題,日益引起人們的重視,能否通過臨床檢測相關(guān)敏感指標(biāo)識別這類高危患者并采取相應(yīng)的干預(yù)措施成為了當(dāng)前研究的重點。目前很多學(xué)者對此進行大量研究表明心血管疾病標(biāo)志物對冠心病及其PCI術(shù)后的病情變化有一定的預(yù)測判斷價值,其中包括血清cTnI、hs-CPR和IL-6。血清cTnI是一種敏感性極高的細(xì)胞損傷因子,能檢測到心肌細(xì)胞微灶性的損傷,hs-CPR和IL-6作為炎性因子,對心肌細(xì)胞的損傷性改變也具有很高的靈敏度。因此,檢測不穩(wěn)定型心絞痛患者PCI術(shù)后血清cTnI、hs-CRP和IL-6的變化,對冠心病及介入治療后的病情檢測和預(yù)后判斷有重要參考價值和指導(dǎo)意義。目的研究PCI對不穩(wěn)定型心絞痛患者血清hs-CRP和IL-6的影響,為不穩(wěn)定型心絞痛患者的病情監(jiān)測及預(yù)后等提供臨床參考依據(jù)。方法對符合條件的40例UAP患者(觀察組)進行經(jīng)皮冠脈介入治療以及20例疑診冠心病且同期冠脈造影結(jié)果正常者(對照組),在術(shù)前和術(shù)后分別抽取肘靜脈血6 ml,分離血清,測定研究對象術(shù)前、術(shù)后1h、6h、12h和24h血清cTncTnI、hs-CRP和IL-6水平,并進行相關(guān)的統(tǒng)計學(xué)分析。結(jié)果①.觀察組術(shù)前血清cTnI、hs-CRP、IL-6水平分別為(1.82±0.49)μg/L、(3.96±0.54) mg/L、(11.27±6.33) pg/L,高于對照組術(shù)前(0.21±0.11)μg/L、(1.76±0.67) (3.95±1.26) pg/L,差異均具有統(tǒng)計學(xué)意義(P0.01)②.觀察組術(shù)后6h、12h、24h血清cTnI水平均高于術(shù)前(P0.05),術(shù)后1h、6h、12h、24h血清hs-CRP水平高于術(shù)前(P0.05),術(shù)后6h、12h血清IL-6水平均高于術(shù)前(P0.05)。③.對照組冠狀動脈造影檢查后1h、6h、12h、24h血清cTnI、hs-CRP和IL-6水平與檢查術(shù)前相比,差異均不具有統(tǒng)計學(xué)意義(P0.05)結(jié)論動態(tài)聯(lián)合檢測血清cTnI、hs-CRP及IL-6對不穩(wěn)定型心絞痛PCI術(shù)后患者制定藥物干預(yù)方案和病情監(jiān)測具有一定的參考價值。
[Abstract]:Background Coronary heart disease (CHD) is the most common and most harmful heart disease. It is a serious threat to human health and an important disease threatening people's lives. Unstable angina pectoris (UAP) is a common type of angina pectoris, between stable angina pectoris (SAP) and acute myocardial infarction (AMI). It occurs on the basis of coronary atherosclerosis and is a common type of acute coronary syndrome (ACS). PCI is one of the commonly used treatments for unstable angina pectoris, but some patients suffer from restenosis in stents after PCI. People pay more and more attention to it. Whether we can identify such high risk patients and take corresponding intervention through clinical detection has become the focus of current research. At present, many scholars have done a lot of research to show that cardiovascular disease markers have certain value in predicting the changes of coronary heart disease and its PCI, including serum cTnI,hs-CPR and IL-6.. Serum cTnI is a highly sensitive cell damage factor, which can detect myocardial microfocal damage. Hs-CPR and IL-6 as inflammatory factors, also have a high sensitivity to the damage of cardiomyocytes. Therefore, detecting the changes of serum cTnI,hs-CRP and IL-6 in patients with unstable angina pectoris after PCI has important reference value and guiding significance for the detection of coronary heart disease and the prognosis after interventional therapy. Objective to study the effect of PCI on serum hs-CRP and IL-6 in patients with unstable angina pectoris (UAP) and to provide clinical reference for monitoring and prognosis of patients with unstable angina pectoris (UAP). Methods 40 patients with UAP (observation group) were treated with percutaneous coronary intervention and 20 patients with suspected coronary artery disease (CHD) with normal coronary angiography results (control group). The blood samples of cubital vein were collected before and after operation for 6 ml,. The serum levels of cTncTnI,hs-CRP and IL-6 were measured before operation, 1 h, 6 h, 12 h and 24 h after operation, and the correlation statistical analysis was made. Result 1. The serum cTnI,hs-CRP,IL-6 levels in the observation group were (1.82 鹵0.49) 渭 g / L, (3.96 鹵0.54) mg/L, (11.27 鹵6.33) pg/L, and (0.21 鹵0.11) 渭 g / L, (1.76 鹵0.67) 渭 g / L, (3.95 鹵1.26) pg/L, respectively. The serum cTnI levels in the observation group were higher than those before operation (P0.05), the levels of serum hs-CRP were higher than those before operation (P0.05), and the levels of serum IL-6 were higher than those before operation (P0.05) at 6h and 12h after operation (P0.05), and the levels of serum IL-6 at 12h after operation were higher than those before operation (P0.05). The levels of serum cTnI,hs-CRP and IL-6 in the control group were compared with those before coronary angiography. The difference was not statistically significant (P0.05) conclusion dynamic combined detection of serum cTnI,hs-CRP and IL-6 in patients with unstable angina pectoris after PCI has a certain reference value in the formulation of drug intervention program and disease monitoring.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R541.4
本文編號：2290284
[Abstract]:Background Coronary heart disease (CHD) is the most common and most harmful heart disease. It is a serious threat to human health and an important disease threatening people's lives. Unstable angina pectoris (UAP) is a common type of angina pectoris, between stable angina pectoris (SAP) and acute myocardial infarction (AMI). It occurs on the basis of coronary atherosclerosis and is a common type of acute coronary syndrome (ACS). PCI is one of the commonly used treatments for unstable angina pectoris, but some patients suffer from restenosis in stents after PCI. People pay more and more attention to it. Whether we can identify such high risk patients and take corresponding intervention through clinical detection has become the focus of current research. At present, many scholars have done a lot of research to show that cardiovascular disease markers have certain value in predicting the changes of coronary heart disease and its PCI, including serum cTnI,hs-CPR and IL-6.. Serum cTnI is a highly sensitive cell damage factor, which can detect myocardial microfocal damage. Hs-CPR and IL-6 as inflammatory factors, also have a high sensitivity to the damage of cardiomyocytes. Therefore, detecting the changes of serum cTnI,hs-CRP and IL-6 in patients with unstable angina pectoris after PCI has important reference value and guiding significance for the detection of coronary heart disease and the prognosis after interventional therapy. Objective to study the effect of PCI on serum hs-CRP and IL-6 in patients with unstable angina pectoris (UAP) and to provide clinical reference for monitoring and prognosis of patients with unstable angina pectoris (UAP). Methods 40 patients with UAP (observation group) were treated with percutaneous coronary intervention and 20 patients with suspected coronary artery disease (CHD) with normal coronary angiography results (control group). The blood samples of cubital vein were collected before and after operation for 6 ml,. The serum levels of cTncTnI,hs-CRP and IL-6 were measured before operation, 1 h, 6 h, 12 h and 24 h after operation, and the correlation statistical analysis was made. Result 1. The serum cTnI,hs-CRP,IL-6 levels in the observation group were (1.82 鹵0.49) 渭 g / L, (3.96 鹵0.54) mg/L, (11.27 鹵6.33) pg/L, and (0.21 鹵0.11) 渭 g / L, (1.76 鹵0.67) 渭 g / L, (3.95 鹵1.26) pg/L, respectively. The serum cTnI levels in the observation group were higher than those before operation (P0.05), the levels of serum hs-CRP were higher than those before operation (P0.05), and the levels of serum IL-6 were higher than those before operation (P0.05) at 6h and 12h after operation (P0.05), and the levels of serum IL-6 at 12h after operation were higher than those before operation (P0.05). The levels of serum cTnI,hs-CRP and IL-6 in the control group were compared with those before coronary angiography. The difference was not statistically significant (P0.05) conclusion dynamic combined detection of serum cTnI,hs-CRP and IL-6 in patients with unstable angina pectoris after PCI has a certain reference value in the formulation of drug intervention program and disease monitoring.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R541.4
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