心脏直视手术患者血清肌钙蛋白的测定及临床价值

Clinical value of assaying sreum troponin T and troponin I in patients undergoing open heart surgery

为探讨心脏直视手术患者术后肌钙蛋白 T(CTn T)和肌钙蛋白 I(CTn I)的变化特点及临床价值 ,对 36例施行手术的心脏病患者 ,分别在术前及术后即刻、1天、3天、7天进行血清 CTn T、CTn I和心肌酶 (CK、CK-MB)的动态检测。结果显示 ,患者组转流前 CTn T、CTn I与对照组均呈显著性差异 (P<0 .0 5 ) ,而 CK、CK- MB无显著性差异 (P>0 .0 5 ) ;术后即刻各指标均呈明显升高 ,2 4小时 CTn T、CTn I达到高峰 ,明显高于 CK、CK- MB(1～ 3倍 ) ;术后 7天 CK、CK- MB均降至正常 ,而部分患者 CTn T、CTn I仍处于较高范围。认为 CTn T、CTn I是心外科手术中心肌保护和围手术期心肌损伤的高度敏感、特异指标 ,其变化可反映心肌损伤的程度 ,并对预后有直接影响。

To determine the value of the variety of troponint(CTn-T)and troponinT(CTn-I)in patients with cardiosurgery 36 patients with heart disease underwent surgery were studied,their sequential CTn-T,CTn-I,creatine kinase(CK)and MB isozyme of creatine kinase(CK-MB)were measured just before cardiopulmonary bypass(CPB)and 0,1,3 and 7 days postoperation Results showed that the level of CTn-T and CTn-I of patients before CPB was significantly higher than that of control(P<0 05) The CTn-T,CTn-I and cardia muscle enzyme were very high after cardiosurgery in patients The peak of CTn-T and CTn-I in patients group occured at 24 hours postoperati 7 days after cardiosurgery,CTn-T and CTn-I of patients were still high while their CK or CK-MB lowed to normality This indicates that CTn-T and CTn-I are very sensitive indexs in predicting myocardial injury