冠心病激光心肌血运重建术后的酶学变化(附35例报告)

The post transmyocardial laser revascularization chang es of myocardial enzyme of 35 cases who suffered coronary artery disease

目的 :观察单纯激光心肌血运重建 (TML R)术后心肌受损情况。方法 :测定采用高能二氧化碳激光行TML R治疗的 35例冠心病患者术日晨及打孔结束即刻、术后 8h、16 h、2 0 h、2 4h、术后第 2～ 7天 ,血清心肌酶的变化。结果 :术前血清中均未测出肌酸激酶同工酶 (CK- MB)活性 ,术后即刻均开始明显升高 ,术后 2 0 h达到峰值 ,全组平均为 (17.6± 6 .3) IU/ L,术后第 4天 CK- MB活性消失 ,其峰值与打孔数量呈正相关。结论 :TML R术对心肌产生轻微损伤 ,并随着打孔数量的增加而增加 。

To observe the postoperative myocardial enzyme's changing regularity of the transmyocardial laser revascularization (TMLR) as sole therapy to coronary artery disease and to discuss its cause and clinical sense. Method:Within 35 patients with coronary heart disease the venous serum myocardial enzymes were measured on the preoperative morning,postoperatively at once,the 8th,the 16th,the 20th,the 24th hour and every 6 am from the 2nd to the 7th day.Result:The activity of CK MB had not been found in the preoperative serums,but it began to increase obviously just postoperation and to peak level 20 hours later.The average level was ( 17.6 ± 6.3 ) IU/L.The activity of CK MB disappeared on the postoperative 4th day.And the peak level of the enzyme was positively relevant to the numbers of the holes by laser.Couclusion:Mild injury of myocardium may be produced by TMLR.The amount of myocarolial injury is increased with the number of holes,but it is of small amonut.