心肌钙蛋白Ⅰ在烧伤后渗出期与感染期中的变化  

Cardiac troponin Ⅰ profile at post-burn acute exudation and infection stage

作　　者：伍敏仪[1] 张涛[2] 曾利剑[1] 陈怡霓[1] 吕海峰[1] 

机构地区：[1]暨南大学第四附属医院/广州市红十字会医院中心实验室,广东广州510220 [2]暨南大学第四附属医院/广州市红十字会医院烧伤科,广东广州510220

出　　处：《广东药学院学报》2004年第3期318-319,321,共3页Academic Journal of Guangdong College of Pharmacy

摘　　要：目的 :探讨心肌钙蛋白Ⅰ (cTnⅠ )在烧伤后渗出期与感染期病人血中升高的规律与炎症反应的关系。方法 :采用化学发光法定期检测烧伤患者渗出期 (n =2 5 )和感染期 (n =30 )血中cTnⅠ浓度 ,所有患者予以动态心电图监测。结果 :渗出期患者 ,仅有 11例略升高 ,在 0 .0 5 μg/L～ 0 .16 μg/L之间。感染期 (5～ 14d)呈轻到中度升高 ,平均值比正常参考范围明显升高者 ,见于体表烧伤总面积 >30 % (P <0 .0 0 1)或创面有明显渗出的患者 (P <0 .0 0 2 )。当患者创面有明显渗出或焦痂自然剥离时 ,cTnⅠ水平升至峰值 ,手术切痂后 ,cTnⅠ水平下降。所有患者心电图未发现任何缺血性改变的迹象。结论 :cTnⅠ水平升高揭示烧伤患者存在非缺血性心肌损伤 。Objective: To study the serum cardiac troponin I (cTnⅠ) level in post-burn patients during acute exudation and infection stage. Methods:serum cTnⅠ of post-burn patients at acute exudation stage (25 cases) and acute infection stage (30 cases) were measured by chemiluminescent immunoassay. Daily monitoring of electrocardiogram (ECG) were carried out on all patients to detect if any ischemic cardiac injury had occurred. Results: At acute exudation stage, only 11 cases showed slight increases in their cTnⅠ levels(0.05～0.16 μg/L). At acute infection stage, all patients were found to have slightly to moderately increased cTnⅠ level on one or more occasions. Obvious rising cTnⅠ levels were observed in patients who had total body surface area >30%(P<0.001) or burn wound exudation (P<0.002). cTnⅠ level peaked at the time when there was obvious burn wound exudation or spontaneous separation of eschar; and decreased after excision treatment. ECG shown no sign of ischemic cardiac damage. Conclusions:Non-ischemic cardiac injury occurred in post burn patients. The process is close related to systemic inflammatory respond.

关 键 词：肌钙蛋白Ⅰ 烧伤 炎症 

分 类 号：R644.03[医药卫生—外科学]