心电图联合肌钙蛋白Ⅰ诊断胸部闭合伤合并心肌钝性伤的价值

The diagnostic value of cardiac troponin Ⅰ combined with electrocardiogram in patients with suspected myocardial contusion after blunt chest trauma

目的 探讨心电图联合检测肌钙蛋白Ⅰ（cTnI）诊断胸部闭合伤合并心肌钝性伤的价值.方法 对行肌钙蛋白Ⅰ检测并有心电图记录的78例胸部闭合伤患者的临床资料进行统计分析,比较≥60岁年龄组与＜59岁组cTnI变化的差异.结果 78例患者中,cTnI升高24例,阳性率为29%.36例心电图异常的患者中,cTnI升高16例,阳性率为44%;42例心电图正常的患者中,cTnI升高8例,阳性率为19%,二者相比差异有统计学意义（P＜0.05）.≥60岁年龄组cTnI升高平均值高于＜59岁年龄组,但差异无统计学意义.结论 心电图联合检测肌钙蛋白Ⅰ可有效诊断胸部闭合伤伴心肌钝性损伤.根据心电图变化检测肌钙蛋白Ⅰ既可提高阳性诊断率又可避免不必要的重复检测.

Objective To investigate the diagnostic value of circulating cardiac tropanin Ⅰ combined with eleetrocardiogram in patients with suspected myocardial contusion after blunt chest trauma. Methods Clinical data of 78 patients with blunt chest trauma, the serum level of troponin Ⅰ and electrocardiogram were reviewed. The lev-el of cTnI in different age groups were compared （ 960 years and 〈59 years）. Results Abnormal troponin Ⅰ were detected in 24 patients （29%）. Among 36 with abnormal electrocardiograms, abnormal troponin Ⅰ was detected in 16 patients （44%）. Among 42 has no abnormal electrocardiographic findings, abnormal troponin I was detected in 8 patients （19%）. The difference of abnormal troponin Ⅰ between two groups was significant（P〈0.05）. The level of cTnI in ≥60 years was higher than in 〈59 years, but was not statistically significant. Condusion These results suggest that there is significantly diagaostic value of serum cardiac troponin Ⅰ combined with electrocardiogram in patients with suspected myocardial contusion after blunt chest trauma.