PCI对不稳定型心绞痛患者血清肌钙蛋白、超敏C反应蛋白、白介素-6影响的研究
发布时间：2018-10-23 19:44
【摘要】：背景冠心病(CHD)是目前最常见、危害最大的心脏疾病,严重危害着人类健康,是威胁人们生命的重要疾病。不稳定型心绞痛(UAP)是冠心病心绞痛的常见类型,是介于稳定型心绞痛(SAP)和急性心肌梗死(AMI)之间。它是在冠状动脉粥样硬化病变的基础上发生的,是急性冠脉综合征(ACS)的常见类型。PCI是不稳定型心绞痛常用的治疗方法之一,但随之出现部分患者PCI术后支架内再狭窄的问题,日益引起人们的重视,能否通过临床检测相关敏感指标识别这类高危患者并采取相应的干预措施成为了当前研究的重点。目前很多学者对此进行大量研究表明心血管疾病标志物对冠心病及其PCI术后的病情变化有一定的预测判断价值,其中包括血清cTnI、hs-CPR和IL-6。血清cTnI是一种敏感性极高的细胞损伤因子,能检测到心肌细胞微灶性的损伤,hs-CPR和IL-6作为炎性因子,对心肌细胞的损伤性改变也具有很高的灵敏度。因此,检测不稳定型心绞痛患者PCI术后血清cTnI、hs-CRP和IL-6的变化,对冠心病及介入治疗后的病情检测和预后判断有重要参考价值和指导意义。目的研究PCI对不稳定型心绞痛患者血清hs-CRP和IL-6的影响,为不稳定型心绞痛患者的病情监测及预后等提供临床参考依据。方法对符合条件的40例UAP患者(观察组)进行经皮冠脉介入治疗以及20例疑诊冠心病且同期冠脉造影结果正常者(对照组),在术前和术后分别抽取肘静脉血6 ml,分离血清,测定研究对象术前、术后1h、6h、12h和24h血清cTncTnI、hs-CRP和IL-6水平,并进行相关的统计学分析。结果①.观察组术前血清cTnI、hs-CRP、IL-6水平分别为(1.82±0.49)μg/L、(3.96±0.54) mg/L、(11.27±6.33) pg/L,高于对照组术前(0.21±0.11)μg/L、(1.76±0.67) (3.95±1.26) pg/L,差异均具有统计学意义(P0.01)②.观察组术后6h、12h、24h血清cTnI水平均高于术前(P0.05),术后1h、6h、12h、24h血清hs-CRP水平高于术前(P0.05),术后6h、12h血清IL-6水平均高于术前(P0.05)。③.对照组冠状动脉造影检查后1h、6h、12h、24h血清cTnI、hs-CRP和IL-6水平与检查术前相比,差异均不具有统计学意义(P0.05)结论动态联合检测血清cTnI、hs-CRP及IL-6对不稳定型心绞痛PCI术后患者制定药物干预方案和病情监测具有一定的参考价值。
[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 卤0.49) 渭 g / L, (3.96 卤0.54) mg/L, (11.27 卤6.33) pg/L, and (0.21 卤0.11) 渭 g / L, (1.76 卤0.67) 渭 g / L, (3.95 卤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.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.4
本文编号：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 卤0.49) 渭 g / L, (3.96 卤0.54) mg/L, (11.27 卤6.33) pg/L, and (0.21 卤0.11) 渭 g / L, (1.76 卤0.67) 渭 g / L, (3.95 卤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.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.4
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