急性脑出血患者血清肌钙蛋白动态变化及临床意义

Dynamic changes of plasma cardiac troponin-I and its clinical significance in patients with acute cerebral hemorrhage

目的:探讨急性脑出血(Acute cerebral hemorrhage,ACH)患者血清肌钙蛋白(Cardiac troponinⅠ,cTn-Ⅰ)含量动态变化及其对心肌损伤的诊断价值。方法:研究组ACH患者,检测98例ACH患者发病后<24h、72h、7d及14d时血清cTn-Ⅰ含量,入院时行神经功能缺损评分,并根据神经功能障碍程度分为轻、中、重3组;对照组检测98例健康体检者血清cTn-Ⅰ含量。结果:研究组在发病后24h、72h、7d时血清cTn-I含量与对照组和研究组发病14d时比较显著升高(P<0.01),发病后14d血清cTn-Ⅰ含量与对照组比较差异无统计学意义(P>0.05);神经功能受损程度(National institutes of health stroke scale,NIHSS)评分越高,cTn-Ⅰ含量越高,3组cTn-Ⅰ含量在发病24h、72h、7d比较差异有统计学意义(P<0.05)。结论:急性脑出血早期血清cTn-Ⅰ含量明显升高,提示cTn-Ⅰ可作为早期检测急性脑出血患者心肌损害的一项指标。

Objective： discussion to the dynamic change of Serum cardiac troponin Ⅰ（cTn- Ⅰ ） and the diagnostic value to the myocardial damage from patients with acute cerebral hemorrhage （ACH）.Methods： study a group of 98 ACH patients ; Serum cTn-Ⅰ is measured in 98 patients with acute cerebral hemorrhage （ACH） at 24 h, 72 h, 7 d, 14 d after the outbreak;Measure the nervous impairment when admission to hospital and divide it into mild, medium and heavy according to the dysfunction of nervous system;compare a group of 98 healthy physical testers and check their Serum cardiac troponin Ⅰ （cTn- Ⅰ ） levels.Results： Serum cardiac troponin Ⅰ（cTn- Ⅰ） levels from 98 ACH patients at 24 h, 72 h,7 d after the outbreak are distinctly higher than that from 98 ACH patients at 14 d and 98 healthy physical testers （P〈0.01）. The Serum cardiac troponin Ⅰ （cTn- Ⅰ ） level from the group of 98 ACH patients at 14 d after the outbreak is meaningless in Statistics when compared （P〉0.05） ;the higher the nervous impairment score in NIHSS is, the higher the cardiac troponin Ⅰ （cTn-Ⅰ ） level is. The three cTn-Ⅰ levels are distinctly meaningful when compared at 24 h, 72 h, 7 d after the outbreak （P〈0.05）. Conclusion： the early Serum cardiac troponin Ⅰ （cTn- Ⅰ ） level of patients with acute cerebral hemorrhage （ACH） is obviously rising. So cTn- Ⅰ can be an index to the early investigation of myocardial damage from the patients with acute cerebral hemorrhage （ACH）.