胸部创伤合并心功能和心肌细胞损害的早期监测与临床观察

The early detection and clinical observation of chest trauma combined cardiac function and myocardial cell damage

目的:探讨血清N末端B型钠尿肽原(NT-proBNP)和心脏型脂肪酸结合蛋白(h-FABP)在胸部创伤所致心肌挫伤的早期监测价值,并观察重组人生长激素(rhGH)的治疗效果。方法:选择82例胸部创伤合并心肌挫伤患者(挫伤组)和50例健康人(对照组)为研究对象,挫伤组采用rhGH治疗。血清NT-proBNP检测采用电化学发光免疫分析(ECLIA)法,血清h-FABP检测采用双抗体夹心酶联免疫(ELISA)一步法。结果:治疗前血清h-FABP阳性率(41.4%)显著高于NT-proBNP(29.8%)及心电图(ECG)(17.7%)(P<0.01)。治疗前,胸部创伤合并心肌挫伤患者血清NT-proBNP和h-FABP水平分别与对照组比较差异有统计学意义(P<0.01);治疗后,两者水平均显著低于治疗前(P<0.01),与对照组比较,差异无统计学意义(P>0.05)。胸部创伤合并心肌挫伤患者血清NT-proBNP与h-FABP呈显著正相关(r=0.719,P<0.01),相关性良好。胸部创伤合并心肌挫伤的82例患者经rhGH治疗后,血清NT-proBNP和h-FABP水平达正常,ECG也无异常表现,无一例死亡病例。结论:rhGH对胸部创伤合并心肌挫伤具有临床治疗作用,血清NT-proBNP和h-FABP的联合检测可早期诊断胸部创伤合并心功能及心肌细胞损害,也可观察临床疗效。

Objective：Through the observation of chest trauma caused by myocardial contusion patients serum N - termi- nal pro - B - type natriuretic peptide （ NT - proBNP） and heart - type fatty acid binding protein （ h - FABP） level change, discuss the merger to early cardiac function and myocardial cell damage monitoring value, to observe the clinical efficacy of re- combinant human growth hormone （rhGH） treatment. Methods ： A total of 82 patients with chest trauma combined with myocar- dial contusion （contusion group） and cases of control group as the research object, contusion group using rhGH treatment. Ser- um NT - proBNP detection using electrochemiluminescence immunoassay （ ECLIA ） method, serum h - FABP detection using enzyme- linked immunosorbent assay （ELISA） method. Results：Before treatment serum h - FABP positive rate （41.4%） was statistically higher than NT - proBNP （29.8%） and ECG （ 17.7% ） （ P 〈 0.01 ）. Before treatment NT - proBNP and h - FABP were significantly higher than those in the control group（P 〈 0.01 ）. After treatment level significantly （P 〈 0.01 ）, and the control group there was no significant difference in sex（ P 〉 0. 05 ）. Serum NT- proBNP and h -FABP is a significant posi- tive correlation（ r =0. 719, P 〈 0.01 ）, and the correlation is good. 82 patients after treatment by rhGH, serum NT -proBNP and h - FABP level of normal, ECG and no abnormality, no 1 deaths. Conclusion： rhGH chest trauma to merge myocardial con- tusion therapeutic effect, combined detection of serum NT - proBNP and h - FABP level and can be early diagnosis chest trau- ma combined cardiac function and myocardial cell damage, and clinical curative effect observation.