激光心肌血运重建术围术期心肌酶学和心电图的变化

Changes in myocardial enzymes and electrocardiogram before and after transmyocardial laser revescularization

目的 了解激光心肌血运重建术 (TMLR)围术期心肌酶及心电图的变化规律和影响因素 ,评价TMLR对心肌损伤程度 ,以利防治术后早期相关并发症。方法 采用速率法测定 5 0例TMLR患者围术期心肌酶变化 ,并行标准导联心电图。结果 TMLR后 8小时心肌酶明显升高 (P <0 0 1) ,血清肌酸激酶同工酶 (CK MB) 2 4小时达峰值 (40± 2 4)IU L ,72小时恢复。 41例 (82 % )心电图部分导联出现新的ST T改变。CK MB峰值与打孔数目及激光能量无相关性 (P >0 0 5 )。心电图存在ST段升高组心肌酶与总样本比较差异无显著性 (P >0 0 5 )。结论 TMLR术后早期心肌酶学及心电图呈现一过性心肌损伤改变 ,其改变程度与打孔数目及激光能量无显著相关性 ,术后

Objective To study the changes and effective factors of myocardial enzymes and electrocardiogram (ECG) and evaluate the degree on myocardial damage postoperative transmyocardial laser revescularization (TMLR) for preventing complications Methods Myocardial enzymes was measured by the speed method in 50 patients underwent TMLR during one week postopertively The standard leads ECG were performed Results Myocardial enzymes had increased significantly since 8 hours after TIMLR ( P <0 01), reaching to peak (40±24)IU/L at 24 hours and recovering at 72 hours 41(82%) patients had new ST T changes in partial leads of ECG The maximum of creatine phosphokinase isoen zyme MB (CK MB) had no significant correlation with number of channels and laser energy ( P >0 05) Comparing with all patients, the maximum of CK MB of group with ST segment elevated was different insignificantly ( P >0 05) Conclusion To a certain degree, there was transient damage on myocardium after TMLR But the degree of damage was not correlativ significantly with number of channels and laser energy It was necessary to monitor the changes of myocardial enzymes and ECG for diagnosing and treationg serious damage of myocardium or acute myocardial infarction