分析不同程度烧伤患者心肌酶谱的检验价值

Analysis of the Test Value of Myocardial Zymogram in Patients with Different Degrees of Burn

目的不同程度烧伤患者采用心肌酶谱进行检验的临床价值分析。方法选取该院于2017年2月—2018年12月收治的68例烧伤患者为研究对象,其中,研究组(n=68),轻度烧伤患者、中度烧伤患者均为23例、重度烧伤22例,对照组(n=35)均为健康体检者,未发生烧伤情况,将两组心肌酶谱检测结果进行对比。结果研究组患者心肌酶谱各指标水平[包括HBDH(α-羟基丁酸脱氢酶)、AST(天冬氨酸氨基转移酶)、LDH(乳酸脱氢酶)、CK-MB(肌酸激酶同工酶)和CK(肌酸激酶)]分别为(414.2±14.3)U/L、(106.5±32.1)U/L、(363.6±68.2)U/L、(38.4±15.3)U/L、(311.5±8.3)U/L,均显著高于对照组(136.4±12.4)U/L、(28.3±5.1)U/L、(193.5±5.4)U/L、(12.1±3.4)U/L、(176.6±5.4)U/L(t=85.728、14.229、14.713、9.917、79.896,P=0.000);研究组患者中,CK、LDH、HBDH、CK-MB、AST这5项心肌酶指标检测水平对比,轻度烧伤患者(168.7±15.4)U/L、(31.9±5.7)U/L、(198.6±16.3)U/L、(14.8±3.1)U/L、(200.4±16.6)U/L低于中度烧伤患者(262.3±17.3)U/L、(94.3±13.6)U/L、(296.8±31.6)U/L、(39.5±6.3)U/L、(309.8±31.8)U/L,中度烧伤患者低于重度烧伤患者(363.4±21.3)U/L、(186.5±40.3)U/L、(456.4±62.2)U/L、(50.4±10.3)U/L、(416.6±40.3)U/L,差异有统计学意义(P<0.05);研究组患者中,HBDH、AST、LDH、CK-MB和CK这几项心肌酶谱检测指标阳性率比较,重度烧伤患者90.9%、81.8%、90.9%、90.9%、90.9%高于中度烧伤患者73.9%、60.9%、60.9%、73.9%、60.9%,中度烧伤患者高于轻度烧伤患者52.2%、43.5%、52.2%、60.9%、43.5%,差异有统计学意义(P<0.05)。结论不同程度烧伤患者应用心肌酶谱可以有效反映出烧伤患者的心肌损伤程度。

Objective To analyze the clinical value of myocardial zymograms in patients with different degrees of burn.Methods 68 patients with burns admitted to the hospital from February 2017 to December 2018 were enrolled in the study.Among them,the study group(n=68),mild burn patients,moderate burn patients,of 23 cases each,severe burned patients of 22 cases;and the control group(n=35)were healthy subjects,without any burns.The results of myocardial zymograms were compared.Results The levels of myocardial enzymes in the study group[including HBDH(α-hydroxybutyrate dehydrogenase),AST(aspartate aminotransferase),LDH(lactate dehydrogenase),CK-MB(creatine kinase isozyme)and CK(creatine kinase)]were(414.2±14.3)U/L,(106.5±32.1)U/L,(363.6±68.2)U/L,(38.4±15.3)U/L,(311.5±8.3)U/L,both significantly higher than the control group(136.4±12.4)U/L,(28.3±5.1)U/L,(193.5±5.4)U/L,(12.1±3.4)U/L,(176.6±5.4)U/L(t=85.728,14.229,14.713,9.917,79.896,P=0.000);in the study group,CK,LDH,HBDH,CK-MB,AST of myocardial enzymes indicators detection level were compared,patients with mild burns(168.7±15.4)U/L,(31.9±5.7)U/L,(198.6±16.3)U/L,(14.8±3.1)U/L,(200.4±16.6)U/L,lower than moderate burned patients(262.3±17.3)U/L,(94.3±13.6)U/L,(296.8±31.6)U/L,(39.5±6.3)U/L,(309.8±31.8)U/L,moderate burn patients were lower than severe burn patients(363.4±21.3)U/L,(186.5±40.3)U/L,(456.4±62.2)U/L,(50.4±10.3)U/L,(416.6±40.3)U/L,the difference was statistically significant(P<0.05);in the study group,HBDH,AST,LDH,CK-MB and CK were detected by myocardial zymography and compared with the positive rate of indicators,90.9%,81.8%,90.9%,90.9%,and 90.9% of patients with severe burns,73.9%,60.9%,60.9%,73.9%,and 60.9% higher than those with moderate burns,higher than that of the mild burned patients of 52.2%,43.5%,52.2%,60.9%,and 43.5%,the difference was statistically significant(P<0.05).Conclusion The application of myocardial enzymes in patients with different degrees of burn can effectively reflect the degree of myocardial damage in patients with burns.