非心脏手术围术期心肌酶谱和肌钙蛋白Ⅰ的变化

Perioperative changes of myocardial enzymes and troponin I in patients undergoing noncardiac surgery

目的观察非心脏手术围术期心肌酶谱和肌钙蛋白I(cTnI)的释放规律。方法30例年龄≥60岁择期全麻手术患者,分别在术前、术中、术毕即刻、术后第1天和第2天测定心肌酶谱,包括谷草转氨酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、肌红蛋白(Myo)、α-羟丁氨酸转氨酶(α-HBDH)、线粒体谷草转氨酶(m-AST)和cTnI的值,同时监测HR、BP和ECG。结果cTnI在非心脏手术围术期未发生心肌缺血或心肌梗死的病例中无显著变化,而心肌酶谱则在术毕和术后第1天均有显著升高(P<0·05或P<0·01)或超出参考值上限。结论心肌酶谱在非心脏手术围术期变化显著;cTnI受非心脏手术和麻醉影响较小。

Objective To observe the releasing regularity of myocardial enzymes and troponin I （cTnI） during noncardiac operations. Methods Thirty selective noncardiac surgical patients,age≥60 years old,under general anaesthesia were studied. HR,BP, ECG, the values of myocardial enzymes, cTnI were recorded or measured perioperatively. Results All 30 patients had no any signs of myocardial ischemia or imfarction perioperatively. The level of cTnI was not changed significantly during study, but myocardial enzymes were changed remarkably at the end of operation and on the lst postoperative day（P〈0. O5 or P〈0.01）,some of which even exceeds the upper limit of normal values. Conclusion Cardiac enzymes changed markedly during perioperation noncardiac surgery;and cTnI was infinfuenced less by noncardiac surgery and anesthesia in this study.