心脏脂肪酸结合蛋白在心脏直视手术后心肌损伤中的判定价值  

Early Diagnosis of Myocardial Damage with Heart Fatty Acid-Binding Protein After Open Heart Surgery

作　　者：乔衍礼[1] 程薇[1] 陈庆伟[1] 陈忠堂[1] 

机构地区：[1]山东中医药大学第二附属医院心脏外科,山东济南250000

出　　处：《中国体外循环杂志》2007年第3期136-138,共3页Chinese Journal of Extracorporeal Circulation

摘　　要：目的探讨心脏脂肪酸结合蛋白(HFABP)对心脏直视手术后心肌损伤的判定价值。方法10例行心脏瓣膜置换手术患者,分别于围术期多个时点取挠动脉血,测定血浆HFABP、心肌肌钙蛋白I(cTnI)、肌酸磷酸激酶同工酶(CKMB)的水平。结果血浆HFABP于再灌注后最早达峰值,其峰值与cTnI、CKMB的峰值及主动脉阻断时间呈正相关。结论HFABP判定心脏直视手术后心肌损伤的早期诊断价值及敏感性优于cTnI、CKMB,对于围术期心肌损伤的诊断、预后及心肌保护效果的评价有重要的价值。OBJECTIVE To evaluate the clinical value of heart fatty acid-binding protein（HFABP） in the diagnosis of myocardial damage after open heart surgery.METHODS Ten patients received cardiac valve replacement operation.The radial arterial blood samples were collected serially after reperfusion to measure plasma levels of HFABP,creatine kinase-MB（CKMB） and cardiac troponin-I（cTnI）.RESULTS Plasma HFABP levels peaked earliest after reperfusion.In addition,the maximum plasma HFABP level was predictable immediately after reperfusion.The maximum plasma HFABP level correlated with the maximum plasma CKMB or cTnI level,as well as with the aortic cross-clamp time.CONCLUSION HFABP can be used to evaluate the degree of myocardial damage and myocardial protective effect in open heart surgery during extracorporeal circulation.Measurements of HFABP allow for earlier evaluation of myocardial damage in the acute phase of reperfusion than CKMB and cTnI.Moreover,as indicators for reflecting the myocardial damage,the sensitivity of HFABP are more valuable than CKMB and cTnI.

关 键 词：心脏直视手术 心肌损伤 心脏脂肪酸结合蛋白 诊断 

分 类 号：R654.2[医药卫生—外科学]