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经皮腔冠脉成形术(PTCA)普遍应用于扩张冠脉狭窄。冠脉狭窄处气囊扩张有时可导致血管造影可见的冠脉小旁支阻塞,但无心肌缺血的临床症状,也不清楚在这种情况下心肌是否已受到损坏。广泛应用的肌酸激酶CK-MB和总肌酸激酶活性测定在诊断心肌病损方面不如CK-MB和心脏特异性肌钙蛋白-T的血浆浓度测定灵敏。作者们通过测量这些浓度发现了因旁支阻塞造成的心肌病损。方法:研究21例患者,男16.女5;平均年龄59(33～79岁)。因稳定性(14例)和不稳定性(7例)心绞痛接受常规PTCA治疗。其中7名患者有MI病史。9例狭窄部位位于左前降支,5例位于左旋支,7
Percutaneous transluminal coronary angioplasty (PTCA) is commonly used to dilate coronary artery stenosis. Inflation of the balloon at a coronary stenosis can sometimes lead to occlusion of the coronary artery with a visible coronary artery bypass graft, but no clinical signs of myocardial ischemia, nor to whether or not the myocardium has been damaged in this condition. The widely used determination of creatine kinase CK-MB and total creatine kinase activity is less sensitive than the determination of plasma concentrations of CK-MB and cardiac-specific troponin-T in the diagnosis of cardiac lesions. By measuring these concentrations, the authors found that myocardial lesions were caused by obstruction of the bypass. METHODS: Twenty-one patients, male 16. female 5, were studied; mean age 59 (33-79 years). Conventional PTCA was given for stable (14 cases) and unstable (7 cases) angina. Seven of the patients had a history of MI. Nine of the stenosis sites were located in the left anterior descending branch, 5 in the left circumflex artery, 7