急性肺血栓栓塞血清酶学及肌钙蛋白I的变化研究

The study on change of serum enzymology and troponin I in acute pulmonary thromboembolism

目的探讨急性肺血栓栓塞血清酶学及肌钙蛋白I的变化。方法选取本院2009年2月～2012年12月诊治的急性肺血栓栓塞患者132例为观察组，根据肺栓塞面积分为3组，非大面积肺栓塞患者47例为观察A组，次大面积肺栓塞患者44例为观察B组，大面积肺栓塞患者41例为观察C组。选取本院同期健康体检人员45例为对照组，均行血清酶学检测和肌钙蛋白I检测。结果观察C组丙氨酸转氨酶、天冬氨酸转氨酶、肌酸激酶、肌酸激酶同工酶、乳酸脱氢酶、肌钙蛋白I及≥0．07μg，L的比率均显著高于观察B组、观察A组、对照组，观察B组上述指标均显著高于观察A组、对照组，观察A组上述指标均显著高于对照组（P〈0．05）。结论急性肺血栓栓塞患者体内血清酶学指标（丙氨酸转氨酶、天冬氨酸转氨酶、肌酸激酶、肌酸激酶同工酶、乳酸脱氢酶）及肌钙蛋白I可显著升高，且肺栓塞面积越大，指标升高越明显。

Objective To discuss the changes of serum enzymology and troponin I in acute pulmonary thromboem- bolism. Methods 132 patients with acute pulmonary thromboembolism admitted into our hospital from February 2009 to December 2012 were selected as the observation group.Based on the areas of pulmonary embolism,they were divided in- to the three groups：the observation group A （47 cases of non-massive pulmonary thromboembolism）,the observation group B （44 cases of sub-massive pulmonary thromboembolism）, and the observation group C （41 cases of massive pul- monary thromboembolism）.Meanwhile,45 healthy people after physical examinations during the same periods in our hospital were chosen as the control group.The tests of serum cnzymology and troponin I were detected. Results In the observation group C,the levels of indexes of serum enzymes like alanine aminotransferase,aspartate transaminase,crea- tine kinase,creatine kinase isoenzyme and lactic dehydrogenase and troponin I and the ratio of troponin 1 I〉0.07 Ixg]L were all remarkably higher than those in the observation group B,the observation group A, and the control group.The levels of above-mentioned indicators in the observation group B were greatly higher than those in the observation group A and the control group.In the observation group A,the levels of above-mentioned indicators were much higher than those in the control group （P〈O.05）. Conclusion The indexes of serum enzymology including alanine aminotransferase, aspartate transaminase,creatine kinase,creatine kinase isoenzyme and lactic dehydrogenase and troponin I can greatly increase in patients with acute pulmonary thromboembolism. The larger area of pulmonary embolism,the more remark- ably these indicators rise.