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冠状动脉旁路移植手术围术期血清肌钙蛋白T水平的变化 被引量:2

Monitoring cardiac troponin T as a marker of perioperative myocardial injury in patients undergoing coronary artery bypass graft surgery
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摘要 目的 探讨肌钙蛋白T作为心肌损伤生化标志物的价值。方法 连续选择冠状动脉旁路移植手术(CABG)患者22 例,分别于麻醉前、体外循环(CPB)前、CPB结束后即刻和CPB后24小时,抽取静脉血4m l,用于肌酸激酶(CK)、肌酸激酶-MB(CK-MB)和心肌肌钙蛋白T(cTnT)的测定。结果 CPB前CK、CK-MB和сTnТ的中位数皆在正常范围内,CPB后即刻和24 小时均显著性增高,CK 以术后24 小时最为明显,其余2 指标以术后即刻最为明显。CK 和cTnT升高的程度无显著性差别,明显高于CK-MB,但cTnT具心肌特异性。结论 cTnT作为心肌损伤标志物,与CK-MB比较,具有在血循环出现早、敏感和特异的特点,可作为监测CABG患者围术期心肌损伤较为可靠的指标。 Objective To determine the value of serum cardiac troponin T(cTnT) as a marker of myocardial cell damage in patients undergoing coronary artery bypass graft surgery (CABG) Methods Twenty two patients with intractable unstable angina,scheduled for CABG,were selected consecutively Serum CK,CK MB and cTnT concentrations were measured before,immediately after and 24h after cardiopulmonary bypass (CPB) Results The median value of CK,CK MB and cTnT levels were all in normal range before CPB,and increased significantly immediately after and 24h after CPB CK level reached the highest value 24h after CPB,whereas CK MB and cTnT levels did immediately after CPB The degree of elevation was not different between CK and cTnT,which was significantly higher than that of CK MB but cTnT was more specific than CK and CK MB Conclusion cTnT is more sensitive and specific than CK and CK MB in predicting early myocardial injury as an reliable perioperative monitoring indicator in patients undergoing CABG
出处 《中华麻醉学杂志》 CAS CSCD 北大核心 1999年第8期453-455,共3页 Chinese Journal of Anesthesiology
关键词 心肌 病理学 冠状动脉分流术 肌钙蛋白 Myocardium Pathology Coronary artery bypass Troponin
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  • 1李成辉,临床麻醉学杂志,1998年,14卷,139页

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