心房颤动导管消融术前后血清心肌酶的变化

Clinical study on serum levels of myocardical enzymes before and after catheter ablation in patients with atrial fibrillation

目的观察心房颤动(房颤)导管消融术前后血清心肌肌钙蛋白I(cTnI)、肌红蛋白(MYO)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)的变化,并以此评估导管消融术对心肌损伤的程度。方法测定49例房颤患者导管消融术前及术后4h的血清cTnI,MYO,CK和CK-MB。结果49例患者导管消融术后比术前心肌酶学各项指标均升高(cTnI2.90±1.67μg/L比0.01±0.00μg/L,MYO70.32±58.96μg/L比23.32±7.01μg/L,CK219.58±117.20U/L比119.79±32.76U/L,CK-MB33.47±16.11U/L比19.63±5.87U/L,P均<0.05)。术后持续性房颤组cTnI为3.82±1.71μg/L,MYO为96.00±72.59μg/L,CK为278.60±130.75U/L,CK-MB为38.40±17.19U/L;阵发性房颤组cTnI为1.88±0.86μg/L,MYO为41.78±12.43μg/L,CK为154.00±49.80U/L,CK-MB为28.00±13.68U/L。组间比较,持续性房颤组cTnI,MYO和CK水平均较阵发性房颤组明显升高(P均<0.05),而两组间CK-MB差异无统计学意义(P>0.05)。结论房颤导管消融术后心肌酶升高,在所有指标中以cTnI最为敏感和特异。

Objective To investigate the level of myocardical injury by measuring serum levels of cTnI, MYO, CK and CK-MB before and after catheter ablation in patients with atrial fibrillation. Methods Forty nine patients underwent catheter ablation for atrial fibrillation were involved in the study, cTnI, MYO, CK and CK-MB levels were measured before and 4 h after catheter ablation. Results Myocardical enzymes were increased in all patients （P 〈 0. 05 ） . Averaged cTnI, MYO, CK and CK-MB levels after catheter ablation were （ 3.82 ± 1.71 ） μg/L, （96. 00 ± 72. 59 ） μg/L, （278. 60 ± 130. 75 ） U/L and （38.40 ± 17.19） U/L in the group of persistent atrial fibrillation, and were （ 1.88 ±0. 86）μg/L, （41.78 ±12.43） μg/L, （154.00± 49.80） U/L and （28.00 ± 13.68） U/L respectively in the group of paroxysmal atrial fibrillation. There were significant differences in the levels of cTnI, MYO and CK between the two groups （ P 〈 0.05 ）, except for CK-MB level （ P 〉 0. 05 ）. Conclusion The serum myocardial enzymes levels increase after catheter ablation for atrial fibrillation. Of the above myocardical enzymes, cTnI is the most sensitive and specific parameters.