血清CK-MB和cTnT水平评估先天性心脏病患儿介入治疗后心肌损伤的价值

Role of serum CK-MB and cTnT in evaluating myocardial damage after interventional therapy in children with congenital heart disease

目的探讨血清肌酸激酶同工酶MB(CK-MB)和心肌钙蛋白T(cTnT)水平评估先天性心脏病(CHD)介入治疗后心肌损伤的价值。方法接受心导管介入封堵术CHD患儿152例分为继发孔型房间隔缺损(ASD组,49例)、膜部室间隔缺损(VSD组,61例)和动脉导管未闭(PDA组,42例)三组,免疫抑制法和化学发光法检测术前、术后即刻及术后48h血清CK-MB和cTnT水平。结果三组患儿术前血清CK-MB和cTnT均在正常水平。ASD、VSD组术后即刻血清CK-MB水平均升高(P<0.05或P<0.01);VSD组术后48h血清CK-MB水平低于术后即刻(P<0.05)。三组术后即刻血清cTnT水平均升高(P<0.05或P<0.01)。三组术后48h血清cTnT水平均下降(P<0.05),但VSD、PDA组仍高于术前(P<0.05)。结论检测血清CK-MB和cTnT两项指标均可用于评估CHD患儿介入治疗后心肌损伤,血清cTnT水平更敏感。

Objective To explore the role of serum creatine kinase MB （CK-MB）and cardiac troponin T （cTnT ） in evaluating myocardial damage after interventional therapy in children with congenital heart disease （CHD ） .Methods A total of 152 children with CHD receiving cardiac catheterization intervention closure was divided into 3 groups of ASD（secundum atrail septal defect , 49 cases） ,VSD（perimembrane ventricular septal defect ,61 cases） and PDA （patent ductus arteriosus , 42 cases） .Serum CK-MB and cTnT were detected by immunosuppression and chemiluminescence before operation（T0） ,immediately after operation （T1） and at 48 hours after operation （T2） .Results Serum CK-MB and cTnT of 3 groups were in normal limits at T0 .Serum levels of CK-MB in groups of ASD and VSD were higher at T1 than those at T0（P〈0 .05 or P〈0 .01） .Serum level of CK-MB in group VSD was lower at T2 than that at T1（P〈0 .05） .Serum levels of cTnT in three groups were all higher at T1 than those at T0（P〈0 .05 or P〈0 .01） ,which at T2 were decreased（P〈0 .05） ,but still higher at T2 than those at T0 in groups of VSD and PDA （P〈0 .05） .Conclusion Serum levels of CK-MB and cTnT can be used as the indicators to evaluate myocardial damage after intervention therapy in CHD children ,but serum cTnT level is more sensitive .