室间隔缺损封堵术前后心肌肌钙蛋白Ⅰ的变化

Cardiac Troponin Ⅰ Is Increased After Interventional Closure of Ventricular Septal Defects

目的:探讨室间隔缺损(VSD)患者介入治疗前后心肌肌钙蛋白Ⅰ(cTnI)的变化规律。方法:42例VSD患者用酶联免疫吸附(ELISA)法检测介入治疗前后不同时间点血清cTnI水平。其中5例患者由于缺损口<1mm,仅行左心室造影未行封堵治疗,为诊断性导管介入组;另37例患者为VSD封堵组。结果:42例患者术前血清cTnI水平均处于正常值(<0.15 ng/ml)范围内。术后即刻、4h、24h及72h,诊断性导管介入组血清cTnI水平与术前比无显著性差异(P>0.05);VSD封堵组术后即刻、4h及24h血清cTnI水平均较术前升高(P均<0.01);两组间比较亦有显著性差异(P均<0.01)。术后72h较24 hVSD封堵组降低但仍高于术前水平,有显著性差异(P<0.05),而两组间比较有显著性差异(P<0.05)。结论:cTnI可以预测心肌微损伤,介入治疗(VSD封堵术)是一种安全、有效、创伤小的治疗方法。

Objective： To examine changes of cardiac troponin Ⅰ（cTnⅠ） after interventional closure of ventricular septal defects（VSD）. Methods： Serial blood samples were taken before, immediately, and at 4,24,72 hours after intervention in 42 VSD patients. The cTnⅠ levels were detected by ELISA at defferent time points. Results： In all patients, serum cTnⅠ levels were at the normal range before intervention. The cTnⅠ levels were significantly increased immediately, and at 4 and 24 hours after intervention in VSD （ P 〈 0.01 ）, but alao significant at 72 hours （ P 〈 0.05 ）. The control group was not associated with the noted cTnⅠ increase （ P 〉 0.05 ）. In 1 case of VSD group the cTnⅠ level was 11.89 ng/ml at 4 hour in the first operation,but he suffered from high degree atrioventricular block（ high AVB） at the third days in the second closure. Conclusion： Serum cTnⅠ concentration may predict minor myocardial damage. Transcatheter closure is a safe, effective and ideal method for the treatment of VSD.