食管癌三野根治术围术期心肌损伤标志物的变化  

Changes of Myocardial Damage Markers during Perioperation of Radical Esophagectomy with Three-Field Lymphadenectomy

作　　者：方卫民[1] 肖振州[1] 

机构地区：[1]福建省肿瘤医院胸外科,福州350014

出　　处：《福建医科大学学报》2007年第5期462-464,共3页Journal of Fujian Medical University

摘　　要：目的了解行三野根治术的食管癌患者围术期心肌损伤标志物的动态变化，评估其监测围术期心肌损伤的价值。方法对96例术前心肌损伤标志物正常的食管癌患者，于术前、术毕、术后1～3d采集静脉血，分别进行谷草转氨酶（AST）、肌酸激酶（CK）、乳酸脱氢酶（LDH）、肌酸激酶MB同工酶（CK—MB）、心肌肌钙蛋白I（cTnI）等心肌损伤标志物的测定，并对检测结果进行统计分析。结果7例围术期≥1次血清cTnI水平超过参考值范围，其中4例被确诊为心肌损伤。余89例均未发现心肌损伤，但术后1d血清AST、LDH、CK及CK—MB均高于术前。结论食管癌患者围术期心肌损伤的生化监测首选心肌肌钙蛋白。Objective To investigate the changes of myocardial damage markers during perioperation of radical esophagectomy with three-field lymphadenectomy and the clinical significance. Methods 96 esophageal carcinoma patients with normal levels of myocardial damage markers before operation were chosen. Changes of aspartate aminotransferase （AST）, creatine kinase （CK）, lactate dehydrogenase （LDH）, MB isoenzyme of creatine kinase（CK-MB）, and cardiac troponin I （cTnI） were detected at different time points. Results The cTnI level of 7 patients rose at least once during perioperation, definite diagnosis of 4 patients associated with myocardial damage. The other 89 patients had no evidence of myocardial damage, but their levels of AST, LDH, CK, and CK-MB the first day after operation were all higher than the preoperative levels. Conclusion Cardiac troponin （CTnI） should be a fit marker for the monitoring of myocardial damage during operation.

关 键 词：食管肿瘤 淋巴结切除术 心肌 生物学标记 肌钙蛋白 肌酸激酶 同工酶 手术时间 

分 类 号：R735.1[医药卫生—肿瘤] R349.23[医药卫生—临床医学]