射频消融术对室上性心动过速并存冠心病患者心肌损伤的探讨

Study on myocardium injury from radiofrequency catheter ablation for tachycardia patients complicated with coronary heart disease

目的 根据心肌酶变化计算射频消融术 (RFCA)后心肌受损量 ,探讨RFCA对室上性心动过速 (室上速 )并存冠心病患者心肌的影响。 方法 90例行RFCA的患者 ,分为冠心病、老年、青年组 ,每组 30例 ,根据其RFCA术前和术后 72h内血清磷酸肌酸激酶 (CK)、磷酸肌酸激酶同工酶 (CK MB)动态变化计算心肌受损量。 结果 冠心病组CK、CK MB恢复正常时间为 (5 2 2 6± 13 35 )h、(36 40± 12 2 0 )h ;CK、CK MB峰值均数为 (2 35 45± 35 2 5 )、(2 3 32± 6 34 )IU/L ;心肌受损量为 (3 6 7±2 13)CK g、(3 41± 2 2 1)CK MB g。冠心病组CK、CK MB恢复正常时间、峰值及心肌受损量均高于老年组及青年组 (P <0 0 5 )。 结论 室上速并存冠心病患者行RFCA时 ,心肌损伤的程度较非冠心病者为重 ,需引起注意。

Objective To calculate the size of myocardial injury due to radiofrequency catheter ablation (RFCA) basing on the changes of patients' serum creatine phosphokinase (CK) and its isoenzyme CK MB and to explore how RFCA influence the myocardia in tachycardia patients with coronary heart disease(CHD). Methods Ninety patients treated with RFCA were divided into three groups, i.e., CHD patients, elderly patients and young patients groups with each group including 30 patients. Before RFCA and within 72 hours after RFCA, CK and CK MB of the patients were determined respectively. The myocardial injury size was calculated basing on the changes of serum CK and CK MB levels. Results It showed from this study that the serum levels of CK and CK MB and the time recovering to normal levels, and the injury size of myocardium in CHD groups were all significantly increased than those in other groups after RFCA (P<0.05). Conclusions RFCA easily causes myocardial injury in tachycardia patients complicated with CHD. Therefore, it is necessary to advise RFCA operators to pay much more attention to these patients.