非心血管疾病患者cTnI和CK-MB升高的回顾性分析

Retrospective analysis of elevated cTnI and CK-MB in patients with non-cardiovascular disease

目的回顾性分析cTnI和CK-MB在非心血管疾病患者中升高的临床诊断情况,探讨cTnI和CK-MB升高的可能原因。方法对近两年我院cTnI和CK-MB检查升高的住院患者进行临床诊断的回顾性分析,结合临床诊断探讨cTnI和CK-MB升高的可能原因。结果先选择了317例cTnI升高患者和2 012例CK-MB升高患者,其中131例cTnI升高患者和884例CK-MB升高患者经诊断属非心血管疾病;cTnI在ICU和神经内科升高较明显,在普外科、呼吸科和肾内科只是轻微升高;CK-MB在神经内科、脑外科和干部病房升高比较明显,而在妇科、康复科和血液科只是轻微升高;cTnI和CK-MB在心血管疾病以外的各种疾病如大手术、严重创伤和出血、器官衰竭、严重疾病状态等都可能升高。结论机体出现急性应激性损伤、血流灌注急骤减少、心肌供血供氧不足、心脏负荷增加、儿荼酚胺释放增加等情况,都可能诱导cTnI和CK-MB的升高。

Objective To retrospectively analyze the clinical diagnosis of cTnI and CK-MB increasing in patients with non-cardiovascular diseases, and to explore possible reasons for cTnI and CK-MB elevation. Methods To retrospectively an alyze the cTnI and CK-MB of hospitalized patients in our hospital in recent two years, and comprehensively explore the reasons for the increasing of cTnI and CK-MB. Results Three hundred and seventeen patients with elevated cTnI and 2 012 patients with elevated CK-MB were collected, and 131 patients with increased cTnI and 884 patients with increased CKMB were diagnosed as non cardiovascular diseases. The cTnI of patients in ICU and the neural department of internal medicine were significantly increased, while they were slightly increased within the patients who were in the department of general surgery, the department of respiration and the renal department of internal medicine. The increasing of CK-MB within patients in department of Neurology, neurosurgery and cadre ward were obviously higher than that in department of gynaecology, department of rehabilitation, and department of hematology. The cTnI and CK-MB may be elevated in various diseases other than cardiovascular disease, such as major surgery, severe trauma and bleeding, organ failure, and severe disease. Conclusion When the body has acute stress injury, blood perfusion will decrease rapidly, myocardial blood supply and oxygen supply will be insufficient, and extra load will be imposed on the heart, catecholamines releasing will be increased, and they are likely to induce the increasing of cTnI and CK-MB, this study provides reference data for clinical diagnosis of patients with elevated cTnI and CK-MB.